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Chaperone Online Registration Form

Online Music in Motion registration form for chaperones

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I will be accompanying a student and wish to stay in a single room at Gruenhagen Conference Center. I will be joining the participants for meals.

$35.00 -- Two-Day Meal Ticket (This fee includes one dinner, one lunch, and appetizers)

$44.00 -- Single-occupancy for Gruenhagen Conference Center (Fee includes breakfast)

$79.00 -- TOTAL to be mailed (Check or Money Order Only - No Cash)

I will be accompanying a student and wish to stay in a single room at Gruenhagen Conference Center. I will not be joining participants for meals.

$44.00 -- Single-occupancy for Gruenhagen Conference Center (Fee includes breakfast)

$44.00 -- TOTAL to be mailed (Check or Money Order Only -- No Cash)

I will be accompanying a student and wish to share a double room at Gruenhagen Conference Center. I will be joining the participants for meals.

$35.00 -- Two-Day Meal Ticket (this fee includes one dinner, one lunch, and appetizers.)

$27.00 -- Double-occupancy for Gruenhagen Conference Center (Fee includes breakfast)

$62.00 -- TOTAL to be mailed (Check or Money Order Only -- No Cash)
please indicate their first and last name




I will be accompanying a student and wish to share a double room at Gruenhagen Conference Center. I will not be joining the participants for meals.

$27.00 -- Double-occupancy for Gruenhagen Conference Center (Fee includes breakfast)

$27.00 -- TOTAL to be mailed (Check or Money Order Only -- No Cash)
please indicate their first and last name




With the submission of this registration form I hereby give permission for images of me, captured during Music in Motion through video, photo, and digital camera, to be used solely for the purposes of University of Wisconsin Oshkosh promotional material and publications, and waive any rights of compensation or ownership thereto.

Please mail check or money order to:

Department of Music/Attn: Music in Motion
University of Wisconsin Oshkosh
800 Algoma Blvd.
Oshkosh, WI 54901

Please make check payable to "UWO Music/Music in Motion"
by musicinmotion last modified Oct 30, 2011 11:58 AM
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