Registration Form

Suzuki Strings & More! Day Camp
Featuring The Steel Wheels Fiddle Workshop
June 29 – July 2, 2015
More information at: www.emu.edu/musiclessons
Please use this simple form to register for any of the 4 options. Check the box for the program(s) in which
you are enrolling your child.
Mail payment with the form to: EMU Preparatory Music, 1200 Park Road, Harrisonburg, VA 22802.
Late Registrations accepted on a space-available basis.
Registration Deadline: June 4, 2015; tuition refunds cannot be given after June 11.
□ The Steel Wheels Fiddle Workshop
$50
Mon-Thurs from 1-3pm at EMU
Performance on Thursday (at EMU) at 3:30 with The Steel Wheels
Jam Session and Performance on July 10 at the
Red Wing Roots Festival
□ Day Camp or Multi-Styles Teen Camp
$195
Mon-Thurs from 9am-3pm at EMU; (Etude in Bk1 and up)
Includes The Steel Wheels Fiddle Workshop
□ Pre-Twinkle/Beginner Camp
$90
Mon-Thurs from 10am-12pmat EMU; (does not include T-shirt)
Parent or Guardian Name:______________________________________________________
Student Name #1:_________________________________________Age:_______ T-shirt size:____
Violin Teacher name:___________________________________________Years of lessons: ____
Session(s) Requested:______________________________________________________________
Student Name #2:_________________________________________Age:_______ T-shirt size:____
Violin Teacher name:___________________________________________Years of lessons: ____
Session(s) Requested:______________________________________________________________
Complete Address:____________________________________________________________________
_____________________________________________________________________________________
Home Phone:_____________________________________Cell Phone:_________________________
E-mail:______________________________________________________________________________
Student E-mail (if applicable):__________________________________________________________
□ Please send me the promo code for the reduced Friday Day Pass to the Red Wing Roots festival.
□ I am requesting a Counselor to accompany my child.
Total fees enclosed: _________________________