Summer Music Camp 2024 Registration Please enable JavaScript in your browser to complete this form.CAMP INCLUDES A T-SHIRT, VIDEO RECORDING OF PERFORMANCE AND PIZZA PARTY! ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼Camp I: It's a HIT! Song Writing ⎪ June 10–14 & June 17–21 (2 Weeks) ⎪ Monday–Friday, 10:00 am–3:00 pm REGISTRATION OPEN In this unique, two-week music camp, campers will have fun working collaboratively and creatively as a band to compose and perform their OWN pop song! In addition to learning music and making friends, campers will have a blast playing games, getting excercise, doing arts and crafts and 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 21. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼Camp II: STAR WARS Keyboard Symphony Orchestra ⎪ June 24–28 & July 8–12 (2 Weeks) ⎪ Monday–Friday, 10:00 am–3:00 pm REGISTRATION OPEN Campers will develop important ensemble playing skills while learning to play the most famous symphonic piece in the galaxy- the Star Wars theme by John Williams! Exclusive to Lake Cook Music Studio, this symphony orchestra is made up of keyboards (using their many instrument sounds), percussion and any other applicable instruments that musicians might play (i.e violin, trumpet, etc.). In addition to learning music and making friends, campers will have a blast playing games, getting excercise, doing arts and crafts and educational activities. This camp will also cover: ⇒ History of the orchestra ⇒ History of the symphony ⇒ Symphonic form and structure ⇒ Tempo, dynamics and phrasing ⇒ Music reading and theory ⇒ Collaboration *Ages 7 and up. Final performance and pizza party: Friday, July 12. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼CHILD'S INFORMATIONSelect Number of children *12345Name *FirstLastDate of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age *7891011121314151617Grade *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: It's a HIT! Song WritingCAMP II: STAR WARS Keyboard Symphony OrchestraPlease 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: It's a HIT! Song WritingCAMP II: STAR WARS Keyboard Symphony Orchestra(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: It's a HIT! Song WritingCAMP II: STAR WARS Keyboard Symphony Orchestra(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: It's a HIT! Song WritingCAMP II: STAR WARS Keyboard Symphony Orchestra(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: It's a HIT! Song WritingCAMP II: STAR WARS Keyboard Symphony Orchestra(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 *⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼ REGISTRATION AND COST Cost is $840.00 per camp. Two or more family members that enroll 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. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼CANCELLATION POLICY Camp fees are non-refundable after the deadline of March, 1 2024. Before the deadline, a refund will be granted minus a non-refundable $400.00 deposit. In some cases, refunds may be granted after the deadline date, minus the $400.00, non-refundable deposit, for medical reasons or emergencies. A written notice of cancellation explaining the circumstances must be provided and in the case of a medical reason, a written doctor’s note must be provided for a refund request to be considered. If LCMS should need to cancel a music camp, you will be presented with the option of receiving a refund based on the number or days cancelled or a credit to your account that may be applied to LCMS programs (future camps, classes, workshops, etc.) Please check the box below to continue *I have read and agree to the Cancellation Policy⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼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. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼ DROP OFF/PICK UP Lake Cook Music Studio 1151 McHenry Rd. Suite 204 Buffalo Grove, IL 60089 *Drop off and pick up for camp is at Suite 204. Camp will start promptly at 10:00 a.m. Students may arrive for camp 15 minutes early. 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. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼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. ⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼⎼ADDITIONAL INFORMATION *Minimum skill requirement: Approximately 4 months of consistent instrument 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. Lunch break will be taken approximately at noon daily. 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 Signature12/21/2024Submit