Summer Music Camp 2023 Registration Please enable JavaScript in your browser to complete this form.CAMP INCLUDES A T-SIRT, AUDIO RECORDING OF PERFORMANCE AND PIZZA PARTY! ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼Camp I: Rock Power! ⎪ June 12-June 16 ⎪ 10:00 am – 3:00 pm REGISTRATION CLOSED Back by popular demand! It sure is a lot of fun playing good ol’ rock and roll and that’s exactly what campers will be doing: Learning the hit song Old Time Rock & Roll by recording artist Bob Seger. In addition to learning music and making friends, campers will have a blast playing games, doing arts and crafts and other educational activities! This camp will also cover: ⇒ Cool sounding intros and endings ⇒ Great sounding “gravy” piano licks and riffs for rock ⇒ Rock accompaniment patterns & bass lines ⇒ The “magic” scale for improvising *Ages 7 and up. Final performance and pizza party: Friday, June 16. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼Camp II: Rhythm & Blues ⎪ June 19-June 23 ⎪ 10:00 am – 3:00 pm REGISTRATION CLOSED Rhythm & Blues forms the nucleus of many other styles of music such as pop, rock, jazz and country. In the 1970s it was widely known as “Soul” and “Funk” and that’s the era this camp will explore. Campers will learn a James Brown tune and the hocket-style of arranging for which he was known: Where each musician’s part fits together like pieces of a puzzle and the sum of these parts creates an amazing sound! In addition to learning music and making friends, campers will have a blast playing games, doing arts and crafts and other educational activities! This camp will also cover: ⇒ 12-Bar Blues song form ⇒ Great sounding “gravy” piano licks and riffs ⇒ Accompaniment patterns & bass lines ⇒ The “magic” scale for improvising ⇒ Cool sounding intros and endings *Ages 7 and up. Final performance and pizza party: Friday, June 23. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼Camp III: It's a Hit! Song Writing ⎪ June 26-June 30 ⎪ 10:00 am – 3:00 pm REGISTRATION CLOSED In this unique kind of music camp, campers will have fun together creating their OWN songs! In addition to learning music and making friends, campers will have a blast playing games, doing arts and crafts and other educational activities. This camp will also cover: ⇒ Pop song structure and form ⇒ How to write a catchy melody ⇒ How to write "the hook” in a song ⇒ Cool sounding intros and endings ⇒ Lyric writing *Ages 7 and up. Final performance and pizza party: Friday, June 30. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼Camp IV: It's a Hit! Song Writing ⎪ July 10-July 14 ⎪ 10:00 am – 3:00 pm REGISTRATION CLOSED In this unique kind of music camp, campers will have fun together creating their OWN songs! In addition to learning music and making friends, campers will have a blast playing games, doing arts and crafts and other educational activities. This camp will also cover: ⇒ Pop song structure and form ⇒ How to write a catchy melody ⇒ How to write "the hook” in a song ⇒ Cool sounding intros and endings ⇒ Lyric writing *Ages 7 and up. Final performance and pizza party: Friday, July 14. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼CHILD'S INFORMATIONSelect Number of children *12345Name *FirstLastDate of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age *567891011121314151617Grade *123456789101112Gender *MaleFemaleCurrent Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePlease select the camp(s) for which you would like to register. *CAMP I: Rock Power!CAMP II: Rhythm & BluesCAMP III: It's a Hit! Song WritingCAMP IV: It's a Hit! Song WritingPlease indicate your child's t-shirt size (youth sizes). *XS (Size 4/5)S (Size 6/8)M (Size 10/12)L (Size 14/16)XL (Size 18/20)(Child 2) Name *FirstLast(Child 2) Date of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(Child 2) Age *567891011121314151617(Child 2) Grade *123456789101112(Child 2) Gender *MaleFemale(Child 2) Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code(Child 2) Please select the camp(s) for which you would like to register. *CAMP I: Rock Power!CAMP II: Rhythm & BluesCAMP III: It's a Hit! Song WritingCAMP IV: It's a Hit! Song Writing(Child 2) Please indicate your child's t-shirt size (youth sizes). *XS (Size 4/5)S (Size 6/8)M (Size 10/12)L (Size 14/16)XL (Size 18/20)(Child 3) Name *FirstLast(Child 3) Date of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(Child 3) Age *567891011121314151617(Child 3) Grade *123456789101112(Child 3) Gender *MaleFemale(Child 3) Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code(Child 3) Please select the camp(s) for which you would like to register. *CAMP I: Rock Power!CAMP II: Rhythm & BluesCAMP III: It's a Hit! Song WritingCAMP IV: It's a Hit! Song Writing(Child 3) Please indicate your child's t-shirt size (youth sizes). *XS (Size 4/5)S (Size 6/8)M (Size 10/12)L (Size 14/16)XL (Size 18/20)(Child 4) Name *FirstLast(Child 4) Date of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(Child 4) Age *567891011121314151617(Child 4) Grade *123456789101112(Child 4) Gender *MaleFemale(Child 4) Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code(Child 4) Please select the camp(s) for which you would like to register. *CAMP I: Rock Power!CAMP II: Rhythm & BluesCAMP III: It's a Hit! Song WritingCAMP IV: It's a Hit! Song Writing(Child 4) Please indicate your child's t-shirt size (youth sizes). *XS (Size 4/5)S (Size 6/8)M (Size 10/12)L (Size 14/16)XL (Size 18/20)(Child 5) Name *FirstLast(Child 5) Date of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(Child 5) Age *567891011121314151617(Child 5) Grade *123456789101112(Child 5) Gender *MaleFemale(Child 5) Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code(Child 5) Please select the camp(s) for which you would like to register. *CAMP I: Rock Power!CAMP II: Rhythm & BluesCAMP III: It's a Hit! Song WritingCAMP IV: It's a Hit! Song Writing(Child 5) Please indicate your child's t-shirt size (youth sizes). *XS (Size 4/5)S (Size 6/8)M (Size 10/12)L (Size 14/16)XL (Size 18/20)⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼PARENT/GUARDIAN'S INFORMATIONName *FirstLastCurrent Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼EMERGENCY CONTACT INFORMATION(PREFERABLY SOMEONE NOT RESIDING WITH YOU)Name *FirstLastRelationship *Phone *⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼HEALTH & SAFETY The health and safety of your child is our top priority. If your child has a low-grade fever or exhibits any symptoms of illness, please keep them home. Any child exhibiting any symptoms of illness will be sent home. Children will remain in the designated rooms in which the camp is being held and not be allowed to wander off. For outdoor activities, children will remain with staff. If a child needs to use the restroom, LCMS staff will escort them to and from the restroom. NOTE: LCMS staff will only release a child to the parents/guardians listed on this form unless prior written notice is given to LCMS by the legal parent/guardian of the child. LCMS may request to see a driver’s license to verify an individual’s identification before releasing the child to the individual. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼MEDIA CONSENT The undersigned hereby consents to and authorizes Lake Cook Music Studio LLC to use captured and/or submitted video/audio recordings and photographic images, musical performances or quoted statements (printed or electronic), or online media for entertainment, educational and promotional purposes and without any compensation to said parties. Furthermore, the undersigned agrees to waive and release any and all claims they may have against LCMS relating to the use of these recordings, images or statements. This Consent is binding upon heirs and future legal representatives. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼CANCELLATION POLICY If you need to cancel your music camp enrollment for any reason, a full refund or credit to your account will be offered up to seven days prior to the camp start date. After that, cancellations are not eligible for a refund or credit If LCMS should need to cancel a music camp, for any reason, you will be presented with the option of receiving a full or partial refund or a credit to your account. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼ DROP OFF/PICK UP Students may arrive for camp 15 minutes early. Camp will start promptly at 10:00 a.m. The main office is located next door in Suite 205-A. The camp will end promptly at 3:00 p.m. and parents/guardians will need to pick their child up at that time. If a parent/guardian is running late, they will need to notify LCMS as soon as possible. If a parent/guardian is more than 15 minutes late picking up their child a second time, they will be charged a $25 late fee and for each late pick up thereafter. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼ REGISTRATION AND COST Cost for each camp is $400.00. If two or more family members enroll, they will receive a 5% discount. NOTE: After submitting this form, an invoice will be sent to the email address you provided. Registration is considered complete and your camp slot secured after payment has been received. When your payment has been received, you will receive an email confirmation and receipt. If a camp is full, you will be notified via email. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼ADDITIONAL INFORMATION *Minimum skill requirement: Approximately 4 months of consistent piano study at LCMS or equivalent or previous music camp experience. Except for the pizza party on the last day of camp, lunch is not provided. Campers should bring their own lunch. NOTE: All songs taught at LCMS camps are kid friendly, regarding lyrics and subject matter. The artist’s own music videos, however, may not be. If this should be the case, only the audio will be played for study. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼I have read and understand the camp policy and agree to abide by its terms. I certify that the information I provided on this form is true and correct. Signature *Clear Signature05/09/2024Submit