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2012 Camper Application

Please note:
Our program is designed for campers aged 12 to 18. On rare occasions exceptions to these age standards are made, but prior approval is necessary. If you feel that your circumstance is such that we should accept your registration even though the age requirements cannot be met, please click here to explain your situation.

Information requested in yellow is required.

CAMPER INFORMATION
Your full name:
Street address:
Apt # or PO Box:
City:
State:
Non USA State or Province
Zip/Postal Code:
Nation:
Telephone:
Email address:
Your school:
Your Grade Next Fall :

Are you a NEW camper to Csehy, or a RETURNING camper?
Male or Female                   Date of birth:

PARENT INFORMATION

Parent/Guardian
full name:
Check here if parent(s) address is same as student's address above
Street address:
Apt # or PO Box:
City:
State:
Zip/Postal Code:
Country:
Telephone:
Email address:
Emergency
Contact Name:		 Emergency
Contact Phone:

STUDY INFORMATION

Please check which week(s) you will be attending. For maximum benefit, it is highly recommended that you attend a full session. Junior high campers may add week 4 with special permission. Email info@csehy.org for details.

Session 1
(Sr. High only)		 Week 1: June 24 to June 30
Week 2: July 1 to July 7 		Fees:

1 week........$700
2 weeks.....$1400
3 weeks.....$2100
4 weeks.....$2800
5 weeks.....$3500

Registration fee: $125, non-refundable. Balance due on or before registration day. This is part of the total fee, not an additional fee.

Key Deposit:
$25 cash key deposit collected on registration day and is returned when key is returned.

Transportation:

Airport Pickup Fee:
(per camper per trip from/to Buffalo or Rochester airport) $50

Please call (610) 623-1326
or (585) 5678-9274 to make transportation arrangements.

Visit our Share a Ride page to arrange travel with other campers in your area.
Session 2
(Sr. High only)


Week 3: July 8 to July 14 Week 4: July 15 to July 21

Session 3
(Jr. High or Sr. High) 		Week 5: July 22 to July 28
For maximum benefit, campers are encouraged to attend for at least two weeks.

Please check your major area of study. This is in addition to your major ensembles (orchestra, band, handbells)  All campers sing in the vocal choir as well.

Piano Voice   Violin   Viola
Cello String Bass   Flute   Oboe
Clarinet Saxophone   Bassoon   French Horn
Trumpet
Baritone   Trombone   Tuba
Percussion Composition *
(see note below)   
   Classical Guitar †
(see note below)   
  
   
* Offered only during weeks 1-4 for campers who meet prerequisites. Contact Mr. Rawleigh for information before sending your registration.  frawleigh@csehy.com

† Offered only during weeks 1-4

Discounts - please check the appropriate box(es):

2nd camper in family($100 discount if you are a multi-week camper, $50 if you are a one-week camper)
3rd camper in family ($150 discount if you are a multi-week camper, $75 if you are a one-week camper)
Referred a new camper who has registered ($467 discount) (camper referred cannot be immediate family member)
      Name of camper(s) you referred:
Child of missionary or pastor ($100 discount if you are a multi-week camper, $50 if you are a one-week camper)
Camper of the session scholorship awarded last season ($50 discount)
Faculty Scholarship awarded last season ($50 discount)
I am not eligible for any discount

Request for roommates (if any): 

Please choose your T-shirt size (adult sizes):

Camper agreement:
"By checking this box I signify that I am willing to abide by the rules and regulations of Csehy Summer School of Music, to meet the practice requirements, and to participate in rehearsals, activities, and Saturday evening performances."

Parent/Guardian agreement:
"By checking this box I signify that I, the parent or guardian of this student, approve this application and assume responsibility for the payment of all fees. I understand that there is no refund for late arrival or early withdrawal or if my son/daughter is sent home because of unsatisfactory behavior. I also understand that his/her participation in the Saturday evening concert is required."