<p> Eric ‘RicStar’ Winter Music Therapy Camp June 8-10, 2015 and June 11-13, 2015 8:30 a.m. - 3:30 p.m. BuddyUp Application</p><p>Name ______Date of Birth ______Address ______City ______State _____ Zip______Phone: Home______Cell______E- mail______*Please let us know if you do not check email regularly as it is our preferred contact method* Shirt Size  Small  Medium  Large  X-large  XX-large  I have one from last year that I can wear. Emergency Contact Information: Name ______Relationship to you ______Phone:  home / work / cell ______ home / work / cell ______Do you have any allergies / health concerns we should be aware of?  Yes  No If yes, please explain ______</p><p>Education & Interests: School ______Grade (13-14 school year)______Do you have a friend or family member with a disability? ______How did you find out about camp? ______I am a  new /  returning (check one) BuddyUp. (This will be my ______year as a BuddyUp.) I am available for: (Please list times if you cannot attend for the entire day.)  All three days of children/adolescent camp (June 8-10).  All three days of adult camp (June 11-13).  Monday, June 8 ______ Thursday, June 11 ______ Tuesday, June 9 ______ Friday, June 12 ______ Wednesday, June 10 ______ Saturday, June 13 ______ I can attend the MANDATORY volunteer training on Wednesday, June 3 from 7:00-8:30pm</p><p> I have completed my Background Check for the 2015 Eric ‘RicStar’ Music Therapy Camp (only necessary if you will be 18 years old on the first day of camp) What are your BuddyUp preferences while working at camp (peer camper, young camper, specific group, etc.)?</p><p>Do you play a musical instrument or sing? What instruments?</p><p>Would you be willing to perform (by yourself) for the campers during camp? If yes, what instrument?</p><p>2</p>