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________________________________________________________________________________________
Print
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2020 GSU MARCHING BAND STAFF
Dr. Nikole M. Roebuck
Director of Bands/Music Department Chair
Grambling State University
roebuckn@gram.edu
Mr. Michael Hendrix
Associate Band Director
Grambling State University
hendrixm@gram.edu
Dr. Edwin Thomas
Associate Band Director
Grambling State University
thomaseb@gram.edu
Mr. Kendall Damond
Assistant Band Director
Grambling State University
damondk@gram.edu
Dr. Steven Cunningham
Assistant Band Director
cunninghams@gram.edu
MS. Janice Cowan
Coordinator of Band Activities
Camp Coordinator
Grambling State University
cowanj@gram.edu
Mr. Michael Price
Band Staff
Grambling State University
pricem@gram.edu
Mr. Chivas Ross
Band Staff
Grambling State University
rossc@gram.edu
Mr. Ricardo Davis
Band Staff
Grambling State University
davisr@gram.edu
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 cowanj@gram.edu
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 5
th
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.