Central Fairfax Band Camp 2024
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Email *
Student First Name: *
Student Last Name: *
Student T-shirt Size *
(In adult sizes)
Current School *
(2023-2024 School Year)
Grade Next Year *
(Rising)
What school will your child attend next year? *
Instrument *
Beginners must choose an instrument before the 1st day of camp.  All students should arrive with an instrument on the 1st day of camp.  Consult your school's band teacher for instrument recommendations.
Years Played on Instrument *
Beginning Band students should select "0"
Home Address *
Number, Apt., and Street Name
City and State *
Zip Code *
Home Phone *
Work Phone *
Parent Cell *
Additional Parent Email *
Would you like to be included in the Carpool List?
If so, please write in your subdivision or nearest elementary school.  A spreadsheet will be emailed out a week before camp begins to those interested in carpooling.  If you are not interested, please leave this line BLANK.
Physician's Name *
Physician's Phone Number *
Please list any medical conditions we should know about in case of an emergency.
Please list an emergency contact name and phone number in the event that we cannot reach you. *
Emergency Care and Student Conduct Agreement
Parent Agreement - The camp has my permission to seek emergency care for my child at the nearest hospital when I or my physician cannot be contacted.  The hospital and its medical staff have my authorization to provide any treatment which a physician deems necessary for the well-being of my child.  I understand that the camp will provide adequate supervision during the operating hours of the camp and will provide full accident insurance for my child while in camp.  I will not hold the camp or the Fairfax County School Board liable for bodily injury that might occur through accident while my child is at the camp beyond the limits of the camp insurance carried for such injury.

Student Agreement - In order to ensure that the Central Fairfax Band Camp is an enjoyable and educational musical experience for all students, it is necessary that each student to accept the responsibility for his/her behavior and to participate in an acceptable manner.  Students must attend all classes while in the building and are not to leave the school grounds.  Areas of the school which are not in use by the camp are off limits to all students.  Failure to adhere to these rules and to follow regulations as established by the Camp staff may result in dismissal from the camp.
Parent and Student Acknowledgement *
PAYMENT
Once you press Submit please return to the homepage and pay for camp by clicking on the 'Buy Now' button.
If the payment’s user information does not match your student’s last name or address, please provide the payment user name & email here. This helps us keep track of which student registration goes with which payment. (Example: student’s last name is different than registering parent’s).
A copy of your responses will be emailed to the address you provided.
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