Summer 2017 Music Camp
July 24-26 3:30-6:00 pm
Student Information
Parent(s) or Guardian Name
Student Age:
Zip Code
Home or Primary Phone
Cell Phonemom
Cell phonedad
Home Church
Behavior Covenant
Parents, please have your child look over each of these requirements. We desire to see each student grow as musicians during their time at Fusion Summer Camp and these behavioral requirements will ensure that your child receives proper training from our instructors.more details
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All students please check each box:
I commit to treating my instructors and staff with respect.
I commit to treating my classmates as I would like to be treated. I will keep my hands and feet to myself.
I will be quiet when asked to do so.
I commit to respecting the property, the classroom, and their contents. For example: I will not deface property, use equipment without permission, or enter rooms to which I'm not assigned.
Student Name
Dateof appointment
FSM intends to foster a caring, safe environment for all students to learn and experience music and the creative arts. We expect that the students will be courteous and respectful of the FSM behavior covenant; however, the instructors and staff will advise all students that the consequences of the difficult behavior are as follows:
1. One warning from instructor
2. If the behavior continues, the student will be removed from the classroom until he/she chooses to act appropriately
3. If the behavior continues after being returned to the classroom, the student will be removed from the classroom, with adult supervision, for the remainder of the class. A parent will need to accompany the student to the next class and he/she must re-sign the FSM Behavior Covenant in order to participate.
I have reviewed this covenant with the student and agree to provide parental support for the FSM Behavior Covenant
Please check each box agreeing with our guidelines and policies (if under 18 yrs of age, parent or guardian please check)
Fusion is not responsible for any damaged or lost instruments, tuners, computers, instrument cases, or any other personal items.
I give permission to Fusion School of Music to use mine or my child's picture and/or video clips in promotional materials.
I give permission to Fusion School of Music to send me e-mails regarding information about camp.
Instrument of Interest
Each student will have the opportunity to experience playing each instrument we offer. However, we would like to know which instrument interested you most!
Instrumentsyou may select more than one
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