Camp Registration Form – Jazz Academy

Which program are you registering for?*

Please fill out the following electronic medical form to provide confidential medical information for each student attending a JAM program

Student Name*

First Last

Student's Email Address*

T-Shirt Size*

This field is hidden when viewing the form

Adult T-shirt Size

Instrument including Vocal and Training

Select your Instrument*

List Other Instrument and/or Multiple instruments here:

Number of Years of Formal Music Training

Previous Training in Jazz Improvisation

Yes
No

Have you been previously enrolled to the JAM Camp?*

Yes
No

If yes, what year did you enroll to the Camp?

School

School's Name*

City*

State*

Grade Entering in Fall 2026*

Student's Home Information

Street Address*

City*

State*

Zip*

Phone

Parent and/or Guardian Declaration

Parent 1 Name*

This field is hidden when viewing the form

Parent 1

Parent's Email Address (Primary)(valid email required)*

Parent 2 Name

Additional Email Addresses

Parent's Daytime Phone*

Additional Phone

Emergency Contacts

Contact 1 Name*

Contact 1 Relationship*

Contact 1 Phone (Camp Hours)*

Contact 2 Name

Contact 2 Relationship

Contact 2 Phone (Camp Hours)

All information is True and Correct*

Yes

Payment Plan (Optional/Select Deposit on Tuition Page)

Available payment options

Are you interested in a private lesson?

Survey Question

How did you hear about the JAM Camps?

Note other source, including teacher here:

2026 Camp Registration Form

Students 6 - 18 years of age.

Instrument including Vocal and Training

School

Student's Home Information

Parent and/or Guardian Declaration

Emergency Contacts

Payment Plan (Optional/Select Deposit on Tuition Page)

Survey Question

About Us

JAM Programs

Donate, Volunteer & Scholarship

Resources

Gallery