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2020 REGISTRATION FORM PLEASE PRINT Full Name __________________________________________ Address _____________________________________________ City______________________________ State _________ Zip___________ Gender _____________ T-Shirt Size ____________ E-mail Address _____________________________________________________ Date of Birth__________________________ Name of School & Address _________________________________________________________________________________ City _________________________________ State _____________ Zip ___________ School Phone ______________________ Instrument ______________________________________________________Grade __________________________________ Director’s Name__________________________________________________ Director’s Cell ___________________________ MEDICAL CONSENT FORM I, the undersigned, hereby grant permission to the Director of Band Camp or his designee to obtain for my child _______________________________________________, general medical services, emergency treatment, and/or Please Print Child’s Name surgery as deemed necessary for the ongoing health and safety of said child by a physician and/or medical facility. I also understand that any/and all pre-existing conditions must be filed under my personal insurance. YOU MUST ATTACH A COPY OF INSURANCE CARD FOR THE STUDENT Please list health issues or restrictions we should know about: _____________________________________________________ ________________________________________________________________________________________________________ Camper’s Signature ________________________________________________________ Date ___________________________ Parents Name ________________________________________________ Cell & Home Phone ___________________________ Please Print Parents Employer ________________________________________________ Work Phone _____________________________ Employers’ Address, City, State, Zip __________________________________________________________________________ Parent’s Signature________________________________________________________________________________________

Cell & Home Phone YOU MUST ATTACH A COPY OF INSURANCE … · 2020. 4. 17. · 2020 GSU MARCHING BAND STAFF Dr. Nikole M. Roebuck Director of Bands/Music Department Chair Grambling

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Page 1: Cell & Home Phone YOU MUST ATTACH A COPY OF INSURANCE … · 2020. 4. 17. · 2020 GSU MARCHING BAND STAFF Dr. Nikole M. Roebuck Director of Bands/Music Department Chair Grambling

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Page 2: Cell & Home Phone YOU MUST ATTACH A COPY OF INSURANCE … · 2020. 4. 17. · 2020 GSU MARCHING BAND STAFF Dr. Nikole M. Roebuck Director of Bands/Music Department Chair Grambling

2020 GSU MARCHING BAND STAFF

Dr. Nikole M. Roebuck Director of Bands/Music Department Chair

Grambling State University [email protected]

Mr. Michael Hendrix

Associate Band Director Grambling State University

[email protected]

Dr. Edwin Thomas Associate Band Director

Grambling State University [email protected]

Mr. Kendall Damond

Assistant Band Director Grambling State University

[email protected]

Dr. Steven Cunningham Assistant Band Director

[email protected]

MS. Janice Cowan Coordinator of Band Activities

Camp Coordinator Grambling State University

[email protected]

Mr. Michael Price Band Staff

Grambling State University [email protected]

Mr. Chivas Ross

Band Staff Grambling State University

[email protected]

Mr. Ricardo Davis Band Staff

Grambling State University [email protected]

ARTICLES TO BRING

Twin Size Toilet Articles Fitted Sheet Towels Pillow/Pillowcases Soap Trash Bags Laundry Bag Housecoat Instruments Blanket Mouth Pieces Drum Major Batons Reeds Drum Mallets Swimsuits Drums Ligatures Shower curtains Personal Instruments PAYMENT Cost per individual………………………….………$335 Minimum Deposit…………………………………..$100 No Pro Rating – Flat Rate of $335, no exceptions $10 Discount-10 or more students per school Make cashier’s checks and/or money orders payable to: Grambling State University Marching Band: Mail to P.O. Box 4238, GSU, Grambling, LA, 71245. Phone: (318) 274-6160 or [email protected] Notification of deposits received will be sent via email. All others receipts will be issued upon arrival NO PERSONAL CHECKS – NO EXCEPTIONS REFUND POLICY Fees are not refundable if entry is canceled after June 15, 2020. All cancel requests must be in writing via email. Cancellations after the above date will be charged a $50 processing fee OPEN TO ELEMENTARY, JUNIOR AND SENIOR HIGH SCHOOL STUDENTS To be eligible, you must at least be in 5th grade in Fall, 2020. AUXILIARY GROUP ACTIVITIES Solo Twirling Dance Units Ensemble Twirling Street Drills Drill Team Routines Drumline Routines Drum Major Workshop Flag Twirling MUSICAL ACTIVITIES Concert Band Marching Band Jazz Ensemble Intermediate & Instrumental Master Classes Beginners Band Percussion Leadership Academy

HOUSING Female Campers……………………………………………..…………..TBA Male Campers…………………………………………………………..…TBA MANDATORY: All chaperones/directors/parents choosing to stay the week are responsible for own lodging elsewhere and meals unless otherwise decided by the Director under extenuating circumstances. All those allowed to stay with exceptions will still be charged the full camp price. NOTE: Toddler babies, children, etc… are not allowed to live on the campus nor allowed in the dormitory rooms. No exceptions. You will be escorted off the campus by university police. LOCATION The University is located in the City of Grambling, Louisiana. Band Camp is held in our new facility, Conrad Hutchinson, Jr. Performing Arts Center located next to Robinson Stadium. AUTOMOBILE Travel interstate 20 and take Grambling exit 70 miles East of Shreveport, LA or 35 miles West of Monroe AIR Purchase tickets to Shreveport or Monroe, Louisiana. Transfer to Greyhound Bus Lines to Grambling Greyhound Bus Terminal. BUS Greyhound buses unload at the Bus Terminal on the Northwest corner on the campus. Note: With proper advanced notice, campers can be picked up from arrival locations. CAMPERS Must wear lanyards (name tags) at all times Social Hour Activities to be chosen from: Talent Show, Movie Night, Dance, Game Night All attire worn must be appropriate and respectable at all times Registration Conrad Hutchinson, Jr., Performing Arts Center 10:00 A.M.– 6:00 P.M., Room 209 Closing Program will be Saturday 10 A.M.