Summer Music Festival Registration - Southwestern College

2024 Registration

Deadline for registration has been extended to May 8, 2024
2024 Summer Music Festival
June 2-8, 2024

More information available at the SCSMF website.

For specific questions, please email Brittany Donals, Director of Camps, Conferences, and Events at Brittany.Donals@sckans.edu.

Through the generous support of V. J. Wilkins Foundation in Cowley County, all students receive aid to attend, thus lowering the cost of tuition to $338 for all campers. Additional scholarship aid based on need and merit is also available. Please mark your request when submitting your registration form.
Festival Participant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
Cell/Alternative*

Area CodePhone Number
Date of Birth*

MonthDayYear
High School Class of*
High School attending*
Gender*

MaleFemaleNon-BinaryTransgender
Statement of Inclusion: Southwestern College is dedicated to providing an atmosphere that nourishes the learning, growth, and personal development of each resident within an inclusive cooperative community. Southwestern strives to accommodate the needs of students to ensure a safe and comfortable living environment.

Southwestern College is highly committed to working with students to find the best living environment, yet due to limited housing options, there is no guarantee that all preferences can be met.

Options may include:
- Live with a preferred roommate or roommate based on compatibility, not gender identity
- Private room or a private studio
- Private bathroom
If you have any additional questions or concerns, please feel free to contact the Director of Camps & Conferences at dir.campconf@sckans.edu or 620-229-6141.
I'd like to request a roommate (write name)
Preferred Pronouns
Shirt Size*
Referred by (if any)
What influenced you to register for SMF? (Check all that apply)

Previous AttendancePoster/BrochureWebsiteKMEA Convention ContactHigh School/Private InstructorSC Faculty/RecruiterFriend
I am a

New participantReturning participant
Please describe any special food allergies or dietary restrictions (if any)
Area of Emphasis
Area of Emphasis*
Vocal Part (if applicable)
Instrument(s)
(List all instruments you play and years of study for each instrument - starting with your primary instrument.)
Name of Music Teacher or Instructor
(current or previous)
Electives

Indicate the elective areas in which you are most interested by order of choice.
Elective - First Choice*
Elective - Second Choice*
Elective - Third Choice*
Waivers & Policies
Medical Consent

I understand and agree that Releasees may not have medical personnel available at the location of the Program. In the event of any medical emergency, select your consent below:
In the event of any medical emergency...*

I DO authorize and consent to any x-ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care that Southwestern College personnel deem necessary for my safety and protection. I understand and agree that Releasees assume no responsibility for any injury, illness, or damage which might arise out of or in connection with such authorized emergency medical treatment. I further understand that in the event that I experience any condition requiring emergency medical treatment, Southwestern College may direct that I be transported to the hospital for such care.I DO NOT authorize and consent to any x-ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care that Southwestern College personnel deem necessary for my safety and protection. I understand and agree that Releasees assume no responsibility for any injury, illness, or damage which might arise out of or in connection with such authorized emergency medical treatment. I further understand that in the event that I experience any condition requiring emergency medical treatment, Southwestern College may direct that I be transported to the hospital for such care.
Emergency Contact Information
Emergency Contact*

First NameLast Name
Emergency Contact Relationship to Participant*
Emergency Contact Phone*

Area CodePhone Number
Emergency Contact Cell/Alternative*

Area CodePhone Number
Emergency E-mail*
Demographic Information

This information is gathered for grant purposes.
Race*

WhiteBlack or African AmericanAmerican Indian or Alaska NativeAsianNative Hawaiian or Other Pacific IslanderTwo or more races
Ethnciity*

Hispanic or LatinoNot Hispanic or Latino
I qualify for Free and Reduced Lunch Program*
I attend a Title IV School*
Cost & Scholarships
Festival Enrollment*

Overnight Camper ($338)Commuter Camper ($338)
Number of persons in addition to festival participant who will attend the June 8th luncheon ($9.10/person)
(Festival participant should not be included in this number)
Total
I have a discount code
Discount Code
SMFFull Enrollment Total
SMFWilkins Enrollment Total
SMFHalf Enrollment Total
SMF200 Enrollment Total
SMF100 Enrollment Total
SMF50 Enrollment Total
Need-based scholarships are available. I am interested in additional scholarship opportunities. Need-based scholarship applications are due by April 19, 2024. For questions, contact us at 620-229-6141.

Yes
Full Balance

Registration is due in total by May 10, 2024.
Payment Method

Online via credit cardCheck by mail

Please mail your Full Balance to:

Director of Camps & Conferences
Southwestern College
100 College St.
Winfield, KS 67156-2499

Checks should be made payable to Southwestern College.
Photo & Video Release
It is vital that Southwestern College keeps updated records of events and an active website which may contain student's photos. Names of students will never be identified.*

As a condition of my participation, I DO grant Southwestern College the right to use, for promotional purposes only, any photographs of me taken by Southwestern College, its employees or agents, during my participation in the Program. I further understand and agree that Southwestern College may use (for marketing purposes) any statements or quotes attributed to me in my evaluation of the Program.As a condition of my participation, I DO NOT grant Southwestern College the right to use, for promotional purposes only, any photographs of me taken by Southwestern College, its employees or agents, during my participation in the Program. I further understand and agree that Southwestern College may use (for marketing purposes) any statements or quotes attributed to me in my evaluation of the Program.
Participant Signature

I hereby acknowledge that I have read, understand, and will abide by each of the terms and conditions of this Agreement. I understand that I may seek legal counsel of my own choosing to fully explain any terms of this Agreement to me before I sign it.
Participant Signature*
Signature of Parent/Guardian for Participants Who Are Minors

I certify that I have custody of Participant or am the legal guardian of Participant by court order. I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND AND AGREE TO ITS TERMS. I AM AWARE THAT THIS AGREEMENT INCLUDES A RELEASE AND WAIVER OF LIABILITY, AN ASSUMPTION OF RISK, AND AN AGREEMENT TO INDEMNIFY RELEASEES.
Signature of Parent/Guardian*
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2024 Registration

Festival Participant Information

Area of Emphasis

Electives

Waivers & Policies

Emergency Contact Information

Cost & Scholarships

Full Balance

Photo & Video Release