fsu SUMMER MUSIC CAMPS

Transcription

1 camper conduct contract Nothing is more important to us than the well-being of our campers. We are vigilant about emotional safety as well as physical safety; about creating a place where campers feel safe, supported in reaching their goals and accomplishing challenges, and where everyone can have fun. To this end, the FSU Summer Music Camps requires all campers and parents to read and agree to the following Camp Rules and Behavior Policies: I WILL SHOW RESPECT FOR OTHERS I will uphold the standards of our community of camp musicians; helping to maintain a safe and welcoming environment, and helping to foster positive relationships between fellow campers as well as with camp staff and instructors. I understand that the FSU Summer Music Camps maintains a bully-free environment, and does not tolerate bullying behaviors in any form including the use of social media. Bullying is when one or more people exclude, tease, taunt, gossip, intimidate, stalk, destroy property, hit, kick, or put down another person with the intent to hurt another or at the expense of someone else. Bullying can also happen through cyberspace: through the use of s, the internet, cell phones, text messaging, instant messaging, social media apps, and other less direct methods. Bullying is inexcusable, and campers that are believed to be bullying or participating in bullying behaviors will be subject to immediate disciplinary actions, up to and including dismissal. I will adhere to University rules and regulations and all codes of conduct while on campus. I WILL USE MY CELL PHONE RESPONSIBLY I understand that I am allowed to have a cell phone for use during free time. My cell phone and all other devices such as smart watches, music players, games, tablets, and other similar devices will be TURNED OFF COMPLETELY and PUT AWAY OUT OF SIGHT during all classes, rehearsals, and performances. I may not take videos or photos during performances with my phone unless I have received prior approval from the Camp Director, Assistant Camp Director, or Dorm Supervisor prior to the event. I understand that if my cell phone is turned on, visible, or being used during class, rehearsals, concerts/performances it may be confiscated according to the following policy by any member of the camp staff: First Offense: The cell phone will be confiscated for the duration of the event/class/rehearsal/etc. but will be returned to me at the end of the event. Second Offense: The cell phone will be confiscated for a period of 24 hours. Third Offense: The cell phone or device will be confiscated for the duration of camp. The item will be returned to me at camp check-out. If my cell phone is confiscated, my parents will still be able to contact me either through the Camp Office or the Southgate Campus Centre. I WILL FOLLOW THE RULES OF THE DORMITORY I will respect the rights, privacy, and property of others. There will be no stealing. There will be no vandalism. Furniture may not be moved from one room to another. I understand that charges will be made for damages to property. Any damages will be billed to the camper s family by the Southgate Campus Center. I will take responsibility for my personal property, room key, and meal card (paying for, if lost). I agree to secure my room at all times to protect my property and the property of my roommates. I understand that there is no room visitation permitted between members of the opposite gender. I understand that practicing my instrument is not permitted at the Southgate Campus Center as it is a residence. Practice rooms are available and monitored in the music buildings. I understand that only music campers are permitted in the residential areas of Southgate. I will follow all rules discussed at Orientation, in small group sessions, and as directed by any member of the camp staff. I WILL TAKE RESPONSIBILITY FOR MY SAFETY AND THE SAFETY OF OTHERS I will not transport other campers in my personal vehicle. If I do transport other campers in my personal vehicle I do so at my own risk and I am responsible for anything that happens to the other camper(s) while in my car. I understand that I may not travel in the personal vehicle of another camper. I understand that due to the risk of fire, motorized vehicles such as motorcycles, mopeds, hoverboards, self-balancing scooter boards, two-wheeled scooters, Segways, carts, etc. are not permitted at camp. I understand that the possession or use of a firearm, knife, pellet gun, air gun, spring loaded or paintball gun, or other weapons on campus is a violation of FSU policy and not permitted on campus or at the FSU Summer Music Camps. Weapons include items that are seemingly harmless but may be used as weapons the so-called dual use items. (i.e. pen/utility knives, box cutters, knives of any length or size, sabers, swords or metal scissors with pointed tips). I will not bring any of these items to camp.

2 I WILL BE RESPECTFUL IN MY USE OF SOCIAL MEDIA AND THE INTERNET I will be respectful in all communications and blogs related to or referencing the camp, its employees, and other campers. I may not post photographs or other likenesses of other campers or employees without the individual s explicit consent. I will not use obscenities, profanity, or vulgar language. I will not harass, bully, or intimidate other campers or employees of the camp. Behaviors that constitute harassment and bullying include, but are not limited to, comments that are derogatory with respect to race, religion, gender, sexual orientation, color, body image, or disability; sexually suggestive, humiliating, or demeaning comments; and threats to stalk, haze, or physically injure another person. I will not discuss engaging in conduct that is prohibited by camp policies, including, but not limited to, the use of alcohol and drugs, sexual behavior, sexual harassment, and bullying. I understand that if I am found to be in violation of any portion of this Social Networking and Internet Policy I am subject to immediate disciplinary action, up to and including dismissal. I WILL NOT POSSESS OR USE ANY ALCOHOL, TOBACCO, VAPING, E-CIGARETTES, OR DRUGS DURING THE CAMP (UNLESS PRESCRIBED BY A PHYSICIAN). Florida State University is a smoke-free campus. Smoking and use of smokeless tobacco products are prohibited at the FSU Summer Music Camps. I understand that the use or possession of any non-prescribed drug, alcohol, marijuana, tobacco products, or any other controlled substance is grounds for automatic dismissal from the Summer Music Camps. I UNDERSTAND THAT IF I VIOLATE THE RULES, REGULATIONS, AND CODE OF CONDUCT FOR THIS CAMP, MY PARENTS WILL BE CONTACTED, AND I SHALL BE SUBJECT TO DISCIPLINARY ACTIONS BY THE DIRECTOR OF CAMPUS LIFE, THE DEAN OF STUDENTS, THE ASSISTANT CAMP DIRECTORS, OR THE CAMP DIRECTOR, UP TO AND INCLUDING DISMISSAL FROM CAMP. Any camper who persistently violates academic or Southgate Campus Centre regulations, the standards of the FSU Summer Music Camps, or standards of Florida State University makes himself/herself liable for dismissal. The breaking of any civil law or city ordinance is grounds for automatic dismissal from the Summer Music Camps. Should you be dismissed for any of these reasons, your parents or guardians will be notified. They will be responsible for your immediate transportation home. Students dismissed from camp at any time will not be reimbursed any funds paid, including tuition, housing, and food payments. I, (Camper Signature), have read, understand, and will abide by the rules and guidelines as stated in this Camper Conduct Contract and in the Camper Handbook. Failure to abide by these policies and guidelines may result in my dismissal from the FSU Summer Music Camps. I, (Parent/Guardian Signature), have read, understand, and will support both my child and the FSU Summer Music Camps in the administration and compliance to the rules and guidelines as stated in this Camper Conduct Contract and in the Camper Handbook. Failure of my child to abide by these policies and guidelines may result in my child s dismissal from the FSU Summer Music Camps.

3 medical information and history form This required form will be used in the event of any necessary medical care for your child and in the event of an emergency. It is imperative that this form be completed in full, with accurate information. If you have any questions about this form, any ongoing medical condition that requires attention, or any other health concern, please call our office at EMERGENCY CONTACT: Mother/Guardian #1 Name: Phone Number: EMERGENCY CONTACT: Father/Guardian #2 Name: Phone Number: EMERGENCY CONTACT: Alternate Name: Phone Number: CAMPER S PRIMARY PHYSICIAN: Name: Office Phone: PART 1: GENERAL MEDICAL INFORMATION Has your child had a tetanus shot within the last 6 years? YES NO Does your child carry a rescue inhaler? YES NO Does your child carry an Epi-Pen? YES NO Is your child allergic to anything? No Known Allergies Amoxicillian Aspirin Ibuprofen Penicillin Sulfonamides (Sulfa Drugs) Significant Current Medical, Behavioral, or Physical Conditions: Does your child have any of the following? None ADD or ADHD Asthma / Breathing Problems Autism Spectrum Disorders Bleeding Disorder Food Allergies Nut Allergies Insect Bites / Stings Seasonal / Environmental Allergies Iodine Products Latex Allergies Cardiac Problem Depression Diabetes (requiring management) Diabetes (requiring low/no management) Eating Disorder Other Allergies or Drug Sensativies: Epilepsy Hearing Problem Vision Problem Other (see details below) Please provide us with detailed information about any other ongoing medical, behavioral, emotional, or physical conditions/treatments or additional information about any of the above conditions. If none, leave blank. You may attach another sheet if needed. Activity Restriction or Assistance: Please provide us with detailed information about any activities which the camper may be restricted from or activities which the camper may need assistance with. If none, leave blank. You may attach another sheet if needed. Page 1 of 3 Continued on next page

4 ALL CAMPERS SHOULD BRING A SUPPLY OF MEDICATIONS WITH THEM TO CAMP. This supply should include common medications (ex: Tylenol, Advil, Benadryl, Tums, etc...) that the camper might need in the event that they don t feel well, and any medications that the camper takes on a regular basis. THE FSU SUMMER MUSIC CAMPS DOES NOT HAVE A SUPPLY OF COMMON MEDICATIONS TO GIVE TO CAMPERS. That means if you don t pack medication for something like a simple headache, the camper will NOT be able to get any medication. Please visit our web site for complete information about medications. PART 2: MEDICATIONS Select one of the two options below for how you would like medications managed for your camper: OPTION 1: I WANT TO GIVE THE MEDICATIONS WE PACK TO CAMP STAFF AND STAFF WILL ADMINISTER AS I DIRECT ON THE ATTACHED INSTRUCTION FORM You will need to provide information about the medications you are brining on a separate sheet that is signed by a parent (required) or the physician (preferred). We have provided a sheet you can use on the following pages of this form, or you can provide an instruction sheet of your own. On the instruction sheet, be sure to include all of the over-the-counter medications you are packing (ex: Tylenol, cough syrup, etc), as well as any daily medications, and/or prescription medications. If you do not have this information yet, or expect it to change by the time camp is here, you always can update the instruction sheet at a later date. OR OPTION 2: I WANT MY CAMPER TO KEEP THE MEDICATIONS WE PACK IN HIS/HER ROOM I request that my child,, be permitted to keep his/her medications on their person or in their room at camp. Below is a list of ALL of the medications that I have packed and that my child will have with them at camp: Acetaminophen (Tylenol) Ibuprofen (Advil, Motrin) Naproxen (Aleve) Antacid (Tums, Milk of Magnesia) Anti-Diarrheal (Immodium AD) Anti-Constipation (Duloclax, Ex-Lax) Oral Antihistamine (Benadryl) Topical Antihistamine (Benadryl) Cough Drops Cough Syrup Daytime Cold Medication (DayQuil) Nighttime Cold Medication (NyQuil) Names of other medications not listed above: (Add a separate sheet if needed. We do not need to know the dose; drug names only) Do any of the medications you are bringing require refrigeration? YES NO I understand and agree that my child will be solely responsible for these medications and for taking them as directed. I understand and agree that it is not permissible for my child to provide medications to other camper(s) and doing so may result in dismissal from camp. I understand and agree that camp staff will not be involved at all with administration of medications to my child. I understand and agree that any medication that my child needs which they do not bring with them to camp may only be received through treatment at a medical facility by a medical professional. Parent/Guardian Signature Date Page 2 of 3 Continued on next page

5 PART 3: INSURANCE Initial in the box to the insurance statement which applies to you: I hereby declare and represent that my Child is NOT covered by an individual or family medical insurance policy and as such, I agree and accept that any and all costs which may be incurred for medical care during the course of the Camp will be solely my responsibility. OR I hereby declare and represent that my Child IS covered by an individual or family medical insurance policy and this policy will be in effect for the duration of Camp. I have provided the required insurance information below, and I understand that it is my responsibility to provide The FSU Summer Music Camps with any updates and/or changes to this insurance information before or during Camp. Policy Holder s Name: Health Insurance Company: Policy Number: Group Number (if applicable): I am providing the required copy of my insurance card below (or on an attached page). I can not provide a copy of my insurance card because I have TriCare and it is my military ID. I have insurance but I can not provide the required copy of my ID because: The space below is provided for you to attach the REQUIRED copy of your insurance card (if applicable) or you may attach it on another sheet if needed. PART 4: FORM AUTHORIZATION Authorization: This health history, medication information, and insurance information is correct to the best of my knowledge and the student herein described has permission to engage in activities, unless otherwise noted by me in writing. I give permission to the University Physical and the University Health Center, or other facility, to hospitalize and to secure proper treatment for my child as named above. Parent/Guardian Signature Date

6 MEDICATION OPTION 1: DOSE/INSTRUCTION FORM FOR STAFF (Use this form only if you selected Option 1 on the Medication section of the Medical Form) LAST NAME (print): FIRST NAME: SIGNAURE OF PARENT OR PHYSICIAN INSTRUCTIONS: Campers who wish to have medications (prescription or non-prescription) administered by camp staff must bring the medications with them to camp. WE DO NOT HAVE A SUPPLY OF MEDICATIONS TO GIVE CAMPERS. Please refer to your Camper Handbook, which explains the camp's policy about medications and how they should be packed Be sure to include all over-the-counter medications you are packing (ie Tylenol, cough syrup, etc), as well as any daily medications, and/or prescription medications. Please provide us with updates for this form as needed if medications change.

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8 statement of voluntary consent READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE FLORIDA STATE UNIVERSITY SUMMER MUSIC CAMPS USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD S RIGHT AND YOUR RIGHT TO RECOVER FROM THE FLORIDA STATE UNIVERSITY SUMMER MUSIC CAMPS IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A LOGICAL PART OF THE CAMP ACTIVITY AND PARTICIPATION. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE FLORIDA STATE UNIVERSITY SUMMER MUSIC CAMPS HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. In consideration of my child s participation in Florida State University Summer Music Camps (Print Camper s Name) ( Camps ) and for other good and consideration received by me, receipt of which is (Print Name of Camp Program(s)) hereby acknowledged, I, having actual knowledge and conscious appreciation of the particular (Print Name of Parent /Guardian) dangers involved in the activities described herein, including, but not limited to sports and recreation activities which may include trips by motor vehicle away from the Florida State University campus, do voluntarily consent to my Child s participation in the aforementioned activities and release The Florida State University ( FSU ) and The Florida Board of Governors, their employees and agents, from liability therefrom and assume the risks arising therefrom and for my child s failure to follow the camp s policies and instructions, such as leaving the camp without permission. I am fully aware that the employees of The Florida State University Summer Music Camps are not medical health professionals and are not responsible for making medical decisions on behalf of my child. I hereby declare and represent that I am aware that for students aged 12 and under and for students without insurance, the The Florida State University Health Center ( Health Center ) is not available and that any necessary medical treatment for students 12 and under would be administered at a local urgent care facility or hospital. I hereby declare and represent that I am aware that Health Center will be utilized for insured students aged 13 and older, if necessary, for the treatment of certain injuries and illnesses which might arise out of the above described activities and I do fully consent to the Health Center providing such treatment. I understand that the treatment would involve the administering of appropriate medication or drugs. I do understand that generally the administering of proper medication or drugs is preferable to leaving the condition untreated; and that violent reaction to medication or drugs could occur. Should routine first-aid or emergency medical needs arise such as cuts, scrapes, bruises, or lacerations, I consent to treatment necessary to prevent infection and promote healing. This would involve, as a matter of accepted medical practice in the community, cleansing and use of topical antibiotic cream/ointment, as appropriate under the circumstances. Regarding major emergencies or medical traumas, I understand that the Health Center professional staff would provide whatever care or treatment they reasonably could and would refer to the appropriate physician/facility the further treatment of such. Should the Health Center be unable to contact me, it is my desire that my child receive such treatment, nonetheless, and I will hold the Health Center harmless for such treatment or referral. I hereby declare and represent that I am aware that employees of The Florida State University Summer Music Camps dormitory staff will administer medications as directed by me or my child s physician unless I have signed a Medication Permission form. I am fully aware that it is my responsibility to provide exact medication information and ample medication at the start of Camp, to provide Camp with updates and/or changes to medication usage and/or dosage for my child, and to ensure that all medications have been given to the counselor on the first day of camp. I understand that my child may not keep medications of any kind in the dorm room unless I have signed a Medication Permission Form and I hereby declare and represent that The Florida State University Summer Music Camps reserves the right to have medication administered by the Health Center if necessary. Being fully aware of the hazards and possible consequences involved in treatment of the above-described routine and major emergency conditions I, being legally competent to give consent, hereby consent to such treatment and agree to hold the Health Center, The Florida State University, and The Florida Board of Governors, their employees and agents, free and harmless from any claims, demands, suits, or damages from any injury or complications whatever which may result from such treatment. In signing this Voluntary Consent, I recognize that additional costs may be incurred as the result of any accident or medical incident involving my child and I will be responsible for such costs, including medical costs, as a result of such accident or injury in connection with the activities associated with my child s participation. I further do hereby consent and agree that the Camp and FSU have the right to utilize photographs or video or audio of Child (and/or property) taken during the Camp program and to use these for educational, promotional or commercial materials, including FSU, Camp web sites and social networking pages. I further consent that Child s name and identity may be revealed therein or by descriptive text or commentary. I do hereby release to FSU all rights to exhibit this work publicly or privately, including posting it on the FSU and Camp web site. I waive any rights, claims or interests I may have to control the use of Child s identity or likeness in the photographs, video, or audio, in perpetuity and agree that any uses described herein may be made without compensation or additional consideration. I do hereby declare and represent that in making, executing, and tendering this Voluntary Consent, I understand and acknowledge the circumstances involved in my child s participation in the described activities, and that I have read this statement, understood its contents, and executed it on my own free will and choice, and do so to benefit the best interests of my child. I represent that I have read and understand the foregoing statement and am competent to execute this agreement. (Youth under 18 must have parent signature) I have executed this document this day of, 20, Parent/Guardian Signature Parent/Guardian Address Relationship To Camper Home Phone Alternate Phone

9 financial responsibility form THIS FORM MUST BE COMPLETED AND SIGNED EVEN IF YOUR BALANCE HAS BEEN PAID IN FULL Because the registered camper is a minor, the parent or legal guardian is responsible for all charges incurred by the camper. This includes the $ deposit (applied towards tuition charges), appropriate tuition amount, and any housing costs. This may also include any third-party scholarship monies promised by an organization such as from a band booster or youth orchestra. You will receive credit automatically for any discount awarded directly from the Summer Music Camps to your son or daughter. All monies are due 14 days before the start of a camp and payment can be made in the form of a check, money order, or credit card. By signing this agreement, a parent or legal guardian agrees to comply with all FSU payment time-lines, policies, and procedures. If you change financial institutions, or make other changes that might affect the processing of payments made for the 2019 Summer Music Camps, please notify the Camp Registrar. To pay online: Go to Select I do not have an FSUID but do have a Customer Number. Your Customer Number was included on your camp confirmation, which you received when you registered. Enter the Customer Number and proceed as directed. You will be assessed a non-refundable convenience fee to cover the cost of the transaction. The amount will be displayed before you commit to completing your payment. To pay by check or money order: Make checks payable to Florida State University and mail to: FSU-CAPD, Attn: Cashier, PO Box , Tallahassee, FL Be sure to reference the student s name and the camp they are attending in the memo portion of the check. Scholarships: If you are receiving a scholarship from a third-party (such as from a band booster or youth orchestra), please make certain these funds have been forwarded to FSU in a timely fashion. Please bring contact information for the person or group awarding the scholarship with you when you arrive for check-in the first day of camp in case there are questions about outstanding balances. If the student is unable to attend camp for any reason, the following refund policy will apply: Written notice received in the camp office 10 or more BUSINESS DAYS (M-F; 8am-5pm) prior to camp check-in: If written notice of cancellation is received 10 or more business days prior to the start of camp you will be refunded tuition and housing payments LESS the $ non-refundable deposit. Written notice received in the camp office 1-9 BUSINESS DAYS (M-F; 8am-5pm) prior to camp check-in: If written notice of cancellation is received 1-9 business days prior to the start of camp, you will be refunded TUITION LESS the $ non-refundable deposit. No housing refund is available at this point. As of 5:00pm on the last business day before camp check-in there are no refunds of any kind. Accepted forms of written notification of cancellation include: Letters mailed to the camp administration office s sent to the camp administration office at musiccamps@fsu.edu Letters faxed to the camp administration office at All of the above methods must be RECEIVED in our office according to the refund policy. Please be sure to get a confirmation from us indicating that your request was received and that the refund is being processed. I have read the above Financial Responsibility Agreement and understand that I, as parent/ legal guardian, am responsible for all charges incurred by my student for the 2019 Summer Music Camps. Parent/Guardian Signature Date Parent/Guardian Name (please print or type)

10 sign-out permission form This form is used to tell us who can sign-out your camper from his/her camp(s). Only persons over the age of 21 may be permitted to sign-out the camper. Please select one of the choices below for Sign-Out: I only want the parent(s)/guardian(s) listed on the campers registration to be able to sign out the camper. If there are custody issues we need to be aware of please contact our office. Otherwise, both parents listed on the registration will be able to sign the camper out. OR I want the parents/guardians listed on the campers registration AS WELL AS the authorized people below, who are over the age of 21, to be able to sign-out the camper. Authorized Person #1: Print Name: Phone Number: Relationship To Camper: Authorized Person #2: Print Name: Phone Number: Relationship To Camper: Authorized Person #3: Print Name: Phone Number: Relationship To Camper: I give permission for my child to leave camp with the person(s) listed above. I understand that only designated adults over the age of 21 may check-out my child from camp, and that he/she must present a valid photo ID at the time of check-out. I understand that my camper may only be signed out from the dormitory office located on the second floor of Southgate. Parent/Guardian Signature

11 housing and dining form This form is OPTIONAL and can be used to tell us about certain special requests for your camper. You only need to fill out this form if any of these situations apply to you. ROOMMATE REQUESTS Roommates are assigned based on age unless a roommate request has been made. Most campers do not submit roommate requests so please don t worry if you do not have someone you know to room with. Camp is about making new friends after all! No, I don t need to request a roommate. No, I don t need to request a roommate but I need to let you know that I DON T want to be roomed with the following person/people: No, I don t need to request a roommate but I want to tell you this about my rooming situation: Yes, I want to request the roommate(s) listed below. PRINT CLEARLY!!! We can t room you with a person if we can t read their name! Request #1: I am attending name of camp and I would like to request the following roommate(s): Name #1: Name #2: Name #3: Request #2: I am attending name of camp and I would like to request the following roommate(s): Name #1: Name #2: Name #3: Request #2: I am attending name of camp and I would like to request the following roommate(s): Name #1: Name #2: Name #3: If you are requesting a roommate(s), please keep the following in mind: You can request up to 3 other persons to room with. All campers in your group must submit their own roommate request, and all requests must include the same people. If your groups requests don t match, then we can not complete the request. Roommates don t have to be going to the same camp, but the camps must have the same check-in and check-out dates. Roommate assignments are NOT confirmed prior to camp. You will find out your room assignment and roommates at check-in. Every effort will be made to honor your request. LATE ARRIVAL TO CAMP Yes, my camper will be arriving late (after the official camp check-in time or on a day that is after the official camp check-in day): Date camper will be arriving: Estimated time of arrival: How will the camper be arriving? With a parent/guardian We are scheduling shuttle service on the Shuttle Request Form. Camper is driving him/herself EARLY DEPARTURE FROM CAMP Yes, my camper will be leaving camp early (one or more days prior to the official end date of camp): Date camper will be leaving: Estimated time of departure: How will the camper be leaving? With a parent/guardian We are scheduling shuttle service on the Shuttle Request Form. Camper is driving him/herself Continued on next page

12 INTERNET ACCESS Campers who are enrolled in an academic summer course can be permitted to use wifi for coursework. Internet access will be limited, available only in the dorm office, and only provided on select evenings when the camper s schedule permits. Campers who need internet access will also need to bring their own computer. I would like to request internet access for my camper because he/she is enrolled in an academic course and will need to submit assignments. DINING REQUESTS FOOD ALLERGIES listed on your medical form will be communicated to the Director of the Southgate Campus Centre. We will give you instructions two weeks prior to the start of your camp for communicating directly with the Southgate Dining Director so that a dining plan can be created. There is no need to repeat food allergies on this form. For religious restrictions or other non-allergy related food restrictions, please know that the dining hall has limited capability to accommodate special dietary concerns. Any seletion made below will be communicated to the Director of the Southgate Campus Centre but we cannot control what options will or won t be provided. We will give you instructions for communicating directly with the Southgate Dining Director two weeks prior to the start of your camp so that a dining plan can be created. VEGAN VEGETARIAN GLUTEN FREE (not celiac) KOSHER Just the alleriges listed on my medical form EXTRA NIGHTS OF HOUSING IN THE DORM Extra nights of housing in the dorm are available to campers who need to arrive the night before or leave the day after camp ends due to travel arrangements. An extra night of housing is REQUIRED if you are arriving any time the day before check-in OR anytime between midnight and 8am on the day of check-in. Extra nights are also available to campers who are attending consecutive camps. For example, Band Camp for Senior High and then Marching Band Leadership and Color Guard Camp. There are some restrictions to the availability of Extra Nights: Extra night stays are limited to one night before and/or one night after your camp starts and ends. Campers at Choral Ensemble Camp, Piano Camp, and Piano Institute can not book an extra night before the start of camp; the earliest these campers can arrive to the dorm is June 9th at 8:00am. Campers at Band Camp for Middle School can not book an extra night at the end of camp; all campers must check-out after the performance on July 13th. The cost of an extra night of housing is $ This includes the extra night in the dorm, full counselor supervision and all extra meals. Checks should be made payable to Florida State University. Payment for extra housing can not be combined with our balance payment of tuition and regular housing - it must be a separate check, but you can use one check to pay for multiple optional items, (for example, you can combine your extra housing payment with a purchase of a CD). It just must be a separate check from the balance of tuition and housing payments. Please fill out the section below and mail it back with payment to: FSU Summer Music Camps, PO Box , Tallahassee, FL I need extra housing in the dorm for the night(s) of: Cost Per Night # Nights Subtotals $50.00 $50.00 $50.00 x 1 x 1 x 1 TOTAL DUE: For Office Use Only: Cash or Check # Amount: Date Received:

13 shuttle service instructions and order form The FSU Summer Music Camps offer pick-up and drop-off service to and from: The Tallahassee Regional Airport (TLH) The Greyhound Bus Station: 112 W. Tennessee Street ( ) The Red Coach Bus Stop: in the student parking lot between Woodward Avenue and Dewey Street. (redcoachusa.com) Transportation to and from these locations is $35.00 round trip for pickup/drop-off that take place between 8am-10:00pm or $50.00 for a pick-up/drop-off between the hours of 10:00pm-8am. There is no discounted price for one way, though you can request transport in only one direction. This service is intended for campers traveling by themselves to and from camp. Though we can make arrangements to take parents in the shuttle as well, you may find it more economical to take a taxi. HOW IT WORKS: Once we have received your shuttle request and payment you will receive a Travel Voucher from us via . This Travel Voucher will serve as a receipt of payment and verification that we have the correct travel information for your child prior to their arrival. It should be presented to the shuttle driver. For Pick-Ups: Campers will be met by a uniformed member of our staff. You will be provided with the name of the driver and a contact number for the day of travel the week before camp begins. Our staff will assist in baggage claim and then bring the camper directly to check-in or to the dorm depending on arrival time. For Drop-Offs: While at camp, campers will work with their counselor to be packed and ready to go at the appropriate time for their return trip. We suggest that airline travel be scheduled no earlier than two hours after the end of the final concert. Please send some kind of identification with your child if possible. The airlines require ID for the camper to check-in for their return flight. HOW TO ARRANGE FOR SHUTTLE SERVICE: The deadline to schedule shuttle service is two weeks prior to the start of your camp. Checks in the amount of $35.00 (for pickup/drop-off that take place between 8:00am-10:00pm) or $50.00 (for pick-up/drop-off between the hours of 10:00pm-8:00am) should be made payable to Florida State University. Please fill out the form, print it and then mail it back with payment to: FSU Summer Music Camps, PO Box , Tallahassee, FL Please allow us three weeks to process your request and send you the Travel Voucher. If you have sent in a Shuttle Service Request Form and have not received your Travel Voucher within three weeks, or if it is less then one week prior to the start of the camp, please contact our office. OTHER THINGS TO KEEP IN MIND: Remember to keep our housing policy in mind when making your travel arrangements. An extra night in the dorm is required if you are arriving the day before check-in, anytime between midnight and 8am on the day of check-in OR departing the day after check-out. You can request an extra night of housing using the Housing and Dining Form. We can help coordinate an early or late check-in for campers taking the shuttle. Discuss the transport of large instruments with your carrier prior to your trip. Please make sure that your camper has plenty of money for any baggage fees which might occur on the trip home. The camps will not pay for excess baggage fees. Campers under the age of 14 traveling alone by plane may be considered an unaccompanied minor by the airline. This means that he/she is required to be picked up by a designated individual. The airline may require the name, address & contact information of that person at the time you book the flight. Please make sure that your camper has some kind of identification on them during travel - especially for the return trip home.

14 shuttle service order form PARENT NAME: What instrument(s) will you have with you during travel? Please check off the option which applies to you: I only need to be picked-up at the beginning of camp I only need to be dropped-off at the end of camp I need to be picked-up and dropped-off Best contact number for PARENT on the DATES OF TRAVEL: ( ) - If the CAMPER will have a cell phone on them during travel, what is that number: ( Physical description of camper (or attach photo): ) - PICK UP DETAILS: Arrival Date: I will be arriving at: Tallahassee Regional Airport Is this camper considered an unaccompanied minor by the airline? Airline: Departure City: Departure Time: Connecting City (if any) Arriving in Tallahassee. Arrival Time: YES NO Flight Number: Greyhound Bus Station on Tennessee Street Departure City: Arrival Time: Bus Number: Red Coach Bus Stop on Tennessee Street Departure City: Arrival Time: Bus Number: DROP-OFF DETAILS: Departure Date: I will be departing from: Tallahassee Regional Airport Is this camper considered an unaccompanied minor by the airline? Airline: YES NO Departure Time: Flight Number: Connecting City (if any) Destination City: Greyhound Bus Station on Tennessee Street Departure Time: Red Coach Bus Stop on Tennessee Street Departure Time: Bus Number: Bus Number: Destination City: Destination City: For Office Use Only: Cash or Check # Amount: Date Received:

15 piano camp: elective form ABOUT ELECTIVE CLASSES During this camp you will take two elective classes each day. Your elective will be assigned on a first-come/first-serve basis. Every effort will be made to give you your first choice. You will find out your elective assignment when you receive your schedule on the first day of camp classes. The deadline to return this form is MAY 26. Campers who have not returned this form by May 26 will be assigned electives based on availability. CLASS DESCRIPTIONS Composition and Arranging - Create your own music! Students will work on original compositions based on works of a variety of styles and composers. World Music - This elective will introduce students to a variety of traditional music from different cultures of the world Duet Piano - This elective will pair students together to play in a piano duet, and introduce students to literature written for Duet Piano. The combination of elective classes I would prefer is: World Music & Composition and Arranging World Music & Duet Piano Composition and Arranging & Duet Piano

16 cd recording and group photo order form DEADLINE: This form may be returned in advance, turned in at camp check-in, or mailed back any time BEFORE JULY 13, Orders received after July 13 will be received but are subject to delayed processing and availability. SHIPPING ADDRESS: Ship To Name: Address: City: State: Zip: CD s are audio recordings - not video. They will be mailed out by the recording company sometime between October and December Group Photos are 8x10 images taken during the final performance. They will be mailed out in July. Camp Name Description of Recording CD Audio Recording Group Photo 8x10 of campers ensemble taken at the final concert Price Quantity Price Quantity Band Camp for Middle School Single CD. Final performance. $18.00 $11.00 Band Camp for Senior High Choral Ensemble Camp Double CD. Contains most pieces from the mid-camp concert and most pieces from the final concert. Double CD. Contains the Small Ensembles concert (Friday PM) and the final concert (Saturday AM). $24.00 $11.00 $24.00 $11.00 Guitar Workshop Single CD. Final performance. $18.00 N/A Honors Chamber Winds Jazz Ensemble Camp: Middle School AND Senior High Single CD. Chamber Ensemble performance (Thursday concert). Purchase the String Orchestra CD if you want a recording of the Saturday Symphony performance. Single CD. Big Bands Concert (Saturday concert). $18.00 $11.00 $18.00 $11.00 Order Subtotal Jazz Ensemble Camp for Senior High Marching Band Leadership and Color Guard Camp Double CD. Combos Concert (Friday evening concert). $24.00 $11.00 N/A $11.00 Piano Camp Single CD. Final recital. $18.00 $11.00 Piano Institute Single CD. Final recital. $18.00 $11.00 String Orchestra Double CD. Contains most pieces from the String Orchestras concert (Fri PM) and the Final Performance (Sat AM). $24.00 $11.00 TOTAL DUE: $ Payment for these items can NOT be combined with your balance payment of tuition and housing. Checks should be made payable to Florida State University. If returning by mail, send form and payment to: FSU Summer Music Camps, PO Box , Tallahassee, FL For Office Use Only: Cash or Check # Amount: Date Received: