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Student Online Registration Form

Online Music in Motion registration form for students

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Please provide first and last name, phone number, and relation
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(xxx) xxx-xxxx
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(adult size)





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If not, roommates will be assigned.


(NOTE: If the roommate you requested is a parent/chaperone, he/she will need to fill out a separate Registration Form)
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I will stay on campus in Gruenhagen Conference Center. I understand that UW Oshkosh will provide one chaperone per 12-15 students.

$75.00 -- Two-Day Event Registration (This registration fee includes one dinner, one lunch, appetizers, a Music in Motion t-shirt, and instruction)

$27.00 -- Double-occupancy for Gruenhagen Conference Center (If you are sharing occupancy with a parent/chaperone, the chaperone must submit a separate Registration Form) (This registration fee includes one breakfast)

$102.00 -- TOTAL to be mailed (Check or Money Order Only - No Cash)

I will attend, but I will not be staying on campus. I understand that I must make my own transportation arrangements to and from campus according to the schedule. As an off-campus participant, I must check in and check out each day.

$75.00 -- Two-Day Event Registration (This registration fee includes one dinner, one lunch, appetizers, a Music in Motion t-shirt, and instruction)

$75.00 -- TOTAL to be mailed (Check or Money Order Only -- No Cash)

With the submission of this registration form I hereby give permission for images of me or my child, 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 12:52 PM
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