NATIONAL HOMESCHOOL MUSIC ENSEMBLES

BAND CAMP APPLICATION SUMMER 2017

 

Family Name....................................................................................................................................

 

Student & Birthday............................................................................................................................

 

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Address: ............................................................................................................................................

 

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City: ........................................................ County: ................State: ........... Zip: ...............................

 

Telephone: Home: ............................................Work: ......................................................................

 

            Cell Phones..........................................................................................................................

 

E-mail addresses: .............................................................................................................................

 

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Band Camp will be held at the Tecumseh Grange at 909 Burt Street in Tecumseh, MI,

from 9:00 a.m. to 3:30 p.m. from Monday, July 17, to Friday, July 21, 2017.

The fee will be $100. Students will perform with the Adrian City Band in Adrian

the following week.  No deposit required.

 

Please send applications  to:

Katherine Johnson

National Homeschool Music Ensembles, Inc.

712 Oxford Street

Ypsilanti, MI  48197-2146

For answers to further questions, telephone Katherine Johnson at 734-905-7282

or write Don Dobrosky at doby7777@gmail.com or call Don at 517-423-4314.

Please send applications early; we need to know how many students to prepare for.

_____________________________________________________________________________

 

NATIONAL HOMESCHOOL MUSIC ENSEMBLES

  MEDICAL RELEASE FORM

            This medical release form is being granted for (students)______________________________ ___________________________________________________________________________

from July 17 to July 21, 2017 during the course of the NHME Summer Band Camp 2017. 

            If my child should need medical assistance, I hereby grant premission to the staff of NHME to obtain medical treatment.  The emergency numbers that I wish to have contacted are:

            1.  _____________________________________________________________

            2.  _____________________________________________________________

My family physician is ___________________________________________________

Physician's phone number: _______________________________________________

                                                Signed, _________________________________________

                                                Date  ___________________________________________

Additional information may be added on the back of this form.