2024 Camp Vivace Registration

* Camp Vivace is a sleep-away SSA camp session for students who will be in grades 9 – 12 in the Fall of 2024, and for graduating seniors in the class of 2024. Campers must have experience playing violin, viola, cello, or bass.

Student Info

Student Name(Required)

First Last

Nickname/Preferred first name(Required)

Date of Birth(Required)

Gender(Required)

Pronouns(Required)

Grade as of Fall 2024(Required)

Presently enrolled at (school name):(Required)

T-shirt size(Required)

Will the student have a birthday while they are at camp?(Required)

Number of years student has attended SSA Summer Music Camp:(Required)

Student's Music Experience

Student's instrument:(Required)

Number of years student has played instrument:(Required)

Number of years of music-reading experience:(Required)

Name of orchestra teacher (type 'none' if no orchestra teacher):(Required)

Number of years of orchestral experience:(Required)

Name of private teacher (type 'none' if no private lessons teacher):(Required)

Number of years of private lessons:(Required)

Please list current solo repertoire, method books (write 'none' if none):(Required)

Parent/Guardian Info

Please enter info for multiple parents/guardians if you'd like:

Parent/Guardian #1 Name(Required)

First Last

Relationship to student:(Required)

Parent/Guardian #1 Phone Number(Required)

Parent/Guardian #1 Secondary Phone Number

Parent/Guardian #1 Email(Required)

Enter Email Confirm Email

Can SSA add your email address to the SSA Mailchimp emailing list?(Required)

We promise not to spam your inbox! We send about one email per month to let folks know about SSA news, such as upcoming SSA Chamber Players concerts and info about Summer Camp and Strings Club registration.

Parent/Guardian #1 Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you want to receive the SSA paper newsletter?(Required)

We mail paper newsletters out about twice a year!

Parent/Guardian #2 Name

First Last

Relationship to student:

Parent/Guardian #2 Phone Number

Parent/Guardian #2 Secondary Phone Number

Parent/Guardian #2 Email

Enter Email Confirm Email

Can SSA add your email address to the SSA Mailchimp emailing list?

Parent/Guardian #2 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you want to receive the SSA paper newsletter?

We mail paper newsletters out about twice a year!

Names of other adult persons to whom your child may be released (these are adults not listed as guardians, type 'none' if none):(Required)

Scholarship

If you wish to apply for a scholarship, please tell us a specific amount of scholarship money you will need from SSA for your child to attend SSA Camp:

Health Information

Allergies(Required)

Please list the student's food, drug, or environmental allergies, if any. Type 'none' if none.

Is the student a vegetarian?(Required)

Is the student a vegan?(Required)

Does the student have any other dietary restrictions?(Required)

Does the student have a history of food issues such as picky eating or eating disorders?(Required)

Medications(Required)

Please list any medications the student will need to take while at SSA Camp. Please explain type of medication, dosage and time administration of medications in detail. Type 'none' if no medications are needed.

Did the student experience any significant physical health issues or events in the last year?(Required)

Should the student's physical activity be restricted for any reason?(Required)

Does the student have any past or current mental health issues we should be aware of?(Required)

Does the student have any social/emotional issues we should be aware of in relation to other students at SSA Camp?(Required)

Does the student have any coping strategies we can use to help during times of emotional distress?(Required)

Is there anything else we should know about the student's health?(Required)

Is there anything else we should know that would help us make SSA Camp the most positive possible experience for the student?(Required)

Insurance

Is the student covered by medical insurance?(Required)

If the student is NOT covered by medical insurance, please type 'none' in all the following prompts.

Name of Insurance Company(Required)

Insurance Company Phone Number(Required)

Group #(Required)

Policy/Member #(Required)

Name of Policy Holder(Required)

Please upload a picture of your insurance card:

Max. file size: 50 MB.

Emergency Contact

Please list an adult who was NOT listed as a parent/guardian. This should be someone we can contact in the event of an emergency, in case we cannot get a hold of any parents/guardians listed above.

Emergency Contact Name(Required)

First Last

Relationship to student:(Required)

Emergency Contact Phone #1(Required)

Emergency Contact Phone #2

Emergency Contact Email(Required)

Emergency Contact Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Authorizations

Parent or guardian, please electronically sign each authorization by typing your full name in each prompt.

Photo/Video Release, please type full name:(Required)

I hereby authorize the use of any photos or video taken of my child during SSA Camp to be used for advertising purposes in posters, brochures, promotional videos, and social media.

Health Information Signature, please type full name:(Required)

I certify that the health information in my child's registration form is true to the best of my knowledge.

Health Care Authorization Statement, please type full name:(Required)

I hereby give my permission to Superior String Alliance to provide routine, nonsurgical medical care, and to secure emergency medical, surgical, and dental treatment for my child in the event of an emergency while she/he/they is/are attending SSA Camp.

SSA Summer Camp Handbook Statement, please type full name:(Required)

I certify that both my child and I, the parent/guardian, have read the SSA Summer Camp Handbook (which includes the Student Code of Conduct) found on SSA's website at https://superiorstringalliance.org/dates-and-tuition/. ***It is really important that you take the time to read this document before registering for camp.***

Camp Tuition Payment

50% of tuition is due by June 15, 2024. Tuition is due in full by July 15, 2024. If you are applying for a scholarship you will receive an email from SSA on the Tuesday after you register letting you know the scholarship amount we are able to give you. We would prefer if you are able to mail a tuition check made out to 'Superior String Alliance' to our address at P.O. Box 52, Marquette, MI 49855. If you need to pay tuition via debit or credit card, please navigate to the SSA website's 'donate' page and you can pay online via our Paypal. Please send us an email at admin@superiorstringalliance.org letting us know that you paid online and the name of your child.

Vaccine Record

SSA will need your child's comprehensive vaccine history (smallpox, rubella, covid, etc). Please email a PDF version of your child's official medical vaccine record to admin@superiorstringalliance.org, or bring a paper copy at camp check-in. Email us with any questions!

Confirmation Emails

You can expect a registration confirmation email and scholarship notification email on the Tuesday after you submit this registration form for SSA Camp. You can also expect a payment confirmation email on the Tuesday after SSA receives your tuition payment.