BandWorks Registration Form – February 2012 Session begins the week of February 6, 2012 I. Personal Info Name: ________________________________________Date of Birth: ____________ Female Male Check here if you are sure we already have your current contact information, then skip to section II. Name of parent or legal guardian (if under 18): ____________________________________________ Address: __________________________________________________________________________ City:__________________________________________ State:_____ Zip:_____________________ Phone: (home)__________________ (cell)______________________ (work) ___________________ Parent’s email (for students under 18): _______________________________________________________ Student’s email: ____________________________________________________________________ Music teacher: (name) _______________________________________________________________ (phone) ___________________________________________________________________________ (email) ___________________________________________________________________________ School Attending (for students under 18): _____________________________________________________ If you are new to BandWorks, how did you hear about us? Friend ____________________ Music teacher School teacher YouTube Web search Newspaper, TV, etc. Flyer/postcard Facebook Other__________________________ Please briefly describe student’s musical experience, including # years experience on your instrument(s), and any band or performing experience you have: _________________________________________________________________________________ _________________________________________________________________________________ II. Instrumentation Please check only ONE instrument as your primary choice: Guitar Bass Drums* Keyboard Vocals Saxophone Trumpet Other __________ Check ANY instruments as your secondary choices in case we are unable to place you on your first choice instrument (If none, please leave blank): Guitar Bass Drums* Keyboard Vocals Saxophone Trumpet Other __________ *Please note that some kids’ bands will have 2 drummers. BandWorks welcomes musicians on a wide range of instruments. Our bands often include flute, violin, cello, percussion and a variety of other instruments. III. Scheduling Please indicate ALL times you are available to rehearse on a weekly basis by checking the appropriate boxes below. The more times you list, the more likely you will get into a band. Only leave a box unchecked if you are sure you cannot make that time. If you are a returning musician, every effort will be made to place you in the same group you have been playing in, unless you tell us otherwise. If you have scheduling preferences or certain musicians with whom you would like to play, please indicate them in the space below. (classes meet once per week) CLASS SCHEDULE Period A Period B Period C Mon.-Thurs. Sat. Mon Tues Period A 4:15–6:15pm 10:15am–12:15pm Period B 6:15–8:15pm 12:15–2:15pm Wed Thurs Period C 8:15–10:15pm 2:15–4:15pm Sat LOCATION (please check as many as are possible): Oakland San Rafael Can you attend the concert date of: Sun. 4/1/12 Yes No (Do not leave blank) Tues. 4/3/12 Yes No (Do not leave blank) If “No,” is there a time issue we can work around: ___________________________________________ Other musicians you’d like to be placed with: ______________________________________________ Scheduling preferences: ________________________________________________________________ IV. Fees, Refunds & Discounts In our effort to offer a very high quality experience for each musician, we balance many different factors in placing students in bands, including: scheduling, age, musical experience, instrumentation, stylistic preferences and other factors. Occasionally we will not have an appropriate fit for a musician, even if he or she registered early. The more days and times you list on your registration form as available, the more likely we will be able to find the right band for you. In the event that we are unable to place you in a band, we will refund your entire registration fee. We do our best to offer the best musical experience possible for all musicians in BandWorks, and work very hard to ensure that your experience is a positive one. In the unlikely event that we are unable to place you in a band this session, please try again next time! Early Registration Discount: Workshop Fee is $375 for registrations received by Monday, 1/23/12. Includes a $100 deposit (non- refundable). Workshop Fee: $395 for registrations received after the deadline of Monday, 1/23/12. Includes a $100 deposit (non-refundable). Refund Policy: There are no refunds after the second class of a session, or for any missed classes. You will be fully refunded if we are unable to place you in an appropriate group. Family Discount: Families with two or more members participating in any classes during the same session will receive a $25 discount per person. This may not be combined with any other coupons or discounts except the Early Registration Discount. V. Media Release: I agree that BandWorks may use any pictures, videos or sound recordings taken of myself or my child during BandWorks rehearsals and performances for the purposes of marketing to the general public. I authorize BandWorks to copy, exhibit, publish or distribute any and all such images for purposes of publicizing BandWorks or for any other lawful purpose. I agree to hold harmless and forever discharge the BandWorks entities from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my or my child(ren)s behalf of my estate have by reason of this authorization. I have read and agree to the fees and policies stated above, and would like to enroll in the next session beginning the week of February 6, 2012. I have enclosed my registration fee (including the non-refundable deposit), and my song suggestions. Sign me up! X________________________________________________________________ Date: _____________ (Must be signed by parent or guardian if under 18) Please mail this form and your song list with your check (payable to BandWorks) to: BandWorks, 2034 Blake St., Suite 9, Berkeley, CA 94704 510-843-BAND(2263) [email protected] Please indicate any song suggestions you may have for the next session on the BandWorks Song List. We thoughtfully consider all suggestions, and make every effort to choose songs that suit the tastes and abilities of the members in each band. Please propose as many songs as you like (the more the better!), including ones that are not on the list. Be sure to include your song suggestions with your registration form. BandWorks Song List Please check all songs you would like to perform in the next session. 1979 - Smashing Pumpkins Back in Black - AC/DC Boulevard of Broken Dreams - Green Day 1985 - Bowling for Soup Back In The Ussr - The Beatles Boys Don't Cry - The Cure 2 Kool 2 be 4-gotten - Lucinda Williams Back On The Chain Gang - The Pretenders Brain Stew - Green Day 21 Guns - Green Day Back to Black - Amy Winehouse Brand New Cadillac - The Clash 0.21875 - The Who Bad Company - Bad Company Brass In Pocket - The Pretenders 86 - Green Day Bad Habit - Offspring Break On Through - The Doors A Change Would Do You Good - Sheryl Bad Luck - Social Distortion Breakdown - Tom Petty Crow Bad Moon Rising - Creedence Clearwater Breathe (2am) - Anna Nalick A Good Horse - The Cardigans Revival Breathe (MM) - Maria McKee A Hard Day's Night - The Beatles Badge - Cream Breathe (PF) - Pink Floyd A Man Of Many Words - Buddy Guy Barracuda - Heart Breathe (U2) - U2 Aces High - Iron Maiden Basket Case - Green Day Brick House - Commodores Aces of Spades - Motorhead Beast Of Burden - The Rolling Stones Broken Hearted Savior - Big Head Todd After Midnight - Eric Clapton Beat on the Brat - The Ramones Brown Sugar - The Rolling Stones Ah Mary - Grace Potter & the Nocturnals Beautiful Day - U2 Brown-Eyed Girl - Van Morrison Ain’t No Sunshine - Horace Andy Beautiful Disaster - 311 Buddy Holly - Weezer Ain't Talkin' 'Bout Love - Van Halen Because - The Beatles Bulls On Parade - Rage Against the Ain't That Peculiar - Marvin Gaye Because the Night - Bruce Springsteen Machine Ain't Wastin' Time No More - Allman Bros. Beds are Burning - Midnight Oil Burn To Shine - Ben Harper Alison - Elvis Costello Before He Cheats - Carrie Underwood Burning Down the House - Talking Heads Alive - Pearl Jam Beggar's Farm - Jethro Tull Busted - Ray Charles All Along the Watchtower - Bob Dylan Behind Blue Eyes - The Who By The Way - Red Hot Chili Peppers All Apologies - Nirvana Bell Bottom Blues - Derek & the Dominoes C'mon Feel the Noize - Slade/Quiet Riot All For You - Sister Hazel Bertha - Grateful Dead Cabron - Red Hot Chili Peppers All My Love - Led Zeppelin Best of You - Foo Fighters Caldonia - BB King All My Loving - The Beatles Beverly Hills - Weezer Caledonia Mission - The Band All Star - Smash Mouth Big Chief - Professor Longhair California (LK) - Lenny Kravitz All These Things That I've Done - The Killers Big Yellow Taxi - Joni Mitchell California (RB) - Robert Bradley All You Need is Love - The Beatles Billionaire - Bruno Mars California Dreamin' - Queen Latifah All Your Love - Otis Rush Bird on a Wire - K.D. Lang Californication - Red Hot Chili Peppers Alone - Susan Tedeschi Bitch - The Rolling Stones Call Me the Breeze - Lynyrd Skynyrd Alone (Heart) - Heart Black - Pearl Jam Callin' San Francisco - Tommy Castro Amaranth - Nightwish Black Dog - Led