Young Artists Division Registration STUDENT INFOSTUDENT Name* First Last Student email (optional)Only provide a student email address if the student to wants to receive Workshop emails from Workshop staff. Age as of today*Birthdate*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Grade (Fall 2025)*School (Fall 2025)*Instrument*Number of years studied on the above instrument*Private instructor name* First Last Private instructor email* Would you like to add a second instrument?*Students will be put into 2 small ensembles. If the student wants to participate on two instruments, and fulfills the requirements, please select yes. Yes No Instrument #2Number of years studied on instrument #2Instrument #2 private instructor name First Last Instrument #2 private instructor email T-shirt size*Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XLPlease select all the student identifies as. This data is only used for grant and funding purposes.* American Indian/Alaskan Native Arab Asian Black/African American Hispanic/Latino Native Hawaiian/Pacific Islander White Multi-Ethnic Other Physically, mentally, or otherwise impaired Prefer not to say PARENT/GUARDIAN INFOMain parent/guardian name*This parent/guardian will be the Workshop staff's main contact for all communications. First Last Main parent/guardian cell phone*Main parent/guardian email* Main parent/guardian address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Would you like to submit a second parent/guardian's information?* Yes No Secondary parent/guardian name First Last Secondary parent/guardian cell phoneSecondary parent/guardian email Secondary parent/guardian address IF different than main parent address Same as main parent/guardian Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Are you interested in carpooling with other families/students to and from the Workshop?*YesNo thanksADDITIONAL INFO ABOUT THE STUDENTIs this the student's first time playing in a chamber ensemble? Has the student attended other summer music camps or programs? If yes, please list.*What repertoire (solos) and technical studies (etudes and scales) is the student currently working on? Please provide specific pieces and/or books.*The more we know about the student and their playing the better we can elevate their overall experience from putting ensembles together, to picking music, and to addressing individual differences and learning needs. Is there any additional information you'd like to share about the student enrolling? (Optional)CONSENTParent(s)/Guardian(s) and Student grant permission to ACMC to use any photos and/or videos taken during the Workshop for non-commercial purposes.*Mainly we use photos/videos to share with our families, patrons, funders, and for grant reporting.Parent(s)/Guardian(s) and Student consentParent(s)/Guardian(s) and Student do not consentParent(s)/Guardian(s) and Student have read, understand and agree to the Workshop policies and guidelines outlined in Workshop Handbook provided on the website.* All parties consentParent(s)/Guardian(s) and Student understand that if Workshop policies outlined in the handbook are not met student will be withdrawn from the program at Workshop staff's discretion without refund.* All parties consentHow did you hear about the Workshop?*Please check all that apply Returning Student ACMC Website ACMC Email ACMC Postcard School Music Teacher Private Lesson Instructor Other CAPTCHA
