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Register for El Sistema Summer Academy
Summer Academy, 2022
New or Returning Student
*
New Student: I have not participated in Longy's Side-by-Side nor the Summer Academy
Returning Student: I have attended either Longy's Side-by-Side or Summer Academy in the past and I can't wait be back!
Placement Video Format
*
All new students will need to submit a placement video to help the artistic directors place students into the appropriate ensemble. Students who have already participated in either the El Sistema Summer Academy or in any seasons of Longy’s Side-by-Side program do not need to submit a video. Please submit a video that includes a scale (multiple octaves preferred) and a short solo piece.
File Upload: I would like to upload my placement video
URL: I would like to share my video through GoogleDrive, YouTube, OneDrive, etc
File Upload
*
Max. file size: 32 MB.
URL
*
Which ensemble(s) was this student part of?
*
String Orchestra
Choir
Symphony Orchestra
Chamber Music
Student Information
Student's Name
*
First
Last
Student's Preferred Name/Nickname
Student's Date of Birth
*
MM slash DD slash YYYY
Student's Preferred Pronouns
*
They, them, theirs
She, her, hers
He, him, his
Call me to discuss
Student's Personal Cell Phone
Is it ok to text student at number above?
Yes
No
Student's Email
*
This is the email that will receive daily schedules and Zoom access links.
Proof of Vaccination
*
Please upload a photo of this student's vaccination card. Only fully vaccinated students are allowed to participate in Longy programs.
Accepted file types: jpg, jpeg, jpejif, jfif, jfi, png, tiff, tif, pdf, , Max. file size: 50 MB.
Is this student Hispanic or Latino?
Not required
Yes
No
Race
Select one or more, as applicable.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Student's Primary Language
*
Amharic
Arabic
Armenian
Bengali
Cajun
Chinese
Croatian
Czech
Danish
Dutch
English
Finnish
Formosan
French
French Creole
German
Greek
Gujarathi
Hebrew
Hindi (urdu)
Hungarian
Ilocano
Italian
Japanese
Korean
Kru
Lithuanian
Malayalam
Miao (hmong)
Mon-khmer (cambodian)
Navaho
Norwegian
Panjabi
Pennsylvania Dutch
Persian
Polish
Portuguese
Rumanian
Russian
Samoan
Serbocroatian
Slovak
Spanish
Swedish
Syriac
Tagalog
Thai (laotian)
Turkish
Ukrainian
Vietnamese
Yiddish
Student's Secondary Language
None
Amharic
Arabic
Armenian
Bengali
Cajun
Chinese
Croatian
Czech
Danish
Dutch
English
Finnish
Formosan
French
French Creole
German
Greek
Gujarathi
Hebrew
Hindi (urdu)
Hungarian
Ilocano
Italian
Japanese
Korean
Kru
Lithuanian
Malayalam
Miao (hmong)
Mon-khmer (cambodian)
Navaho
Norwegian
Panjabi
Pennsylvania Dutch
Persian
Polish
Portuguese
Rumanian
Russian
Samoan
Serbocroatian
Slovak
Spanish
Swedish
Syriac
Tagalog
Thai (laotian)
Turkish
Ukrainian
Vietnamese
Yiddish
Student's Sistema or School Music Program
*
Boston String Academy
Kids 4 Harmony
El Sistema Somerville
Conservatory Lab Charter School
Youth and Family Enrichment Services (YoFES)
Cambridge Public Schools
Boston Public Schools
Student's Daytime School for 2020-'21 School Year
*
Please enter the student's elementary, middle, or high school they will attend for the 2019-20 school year. (This is not the student's music program)
Students Grade level in 2021-'22
*
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade (HS Freshman)
10th Grade (HS Sophomore)
11th Grade (HS Junior)
12th Grade (HS Senior)
College/Conservatory
Student's Instrument
*
Flute
Oboe
Clarinet
Bassoon
Saxophone
French Horn
Trumpet
Trombone
Tuba
Percussion
Piano
Violin
Viola
Cello
Bass
When did the student begin playing this instrument?
*
Please enter an approximate date
MM slash DD slash YYYY
Students Location, August 1, 2021
*
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Student's T-Shirt Size
Youth Extra Small
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Does this student participate in the National School Breakfast and Lunch Program for Massachusetts?
Yes
No
Are there any physical, emotional, intellectual, or social challenges this student faces that you would like to bring to the attention of staff and faculty?
Liability Policy
*
To the fullest extent permitted by law, I, the legal guardian of this student, shall defend, indemnify and hold harmless Longy School of Music, its trustees, directors, officers, employees and agents, from and against all losses, claims, suits, actions, damages and expenses (including attorneys’ fees), arising from (Contracted Party) breach of this Agreement, or (Contracted Party) acts or omissions in performing services under this Agreement, except solely to the extent such Claim is directly and proximately caused by the negligence or willful misconduct of Longy School of Music.
I agree to the liability policy.
Audio and Image Recording Policy Consent
*
By registering to participate in musical activities at Longy, you grant Longy School of Music of Bard College, and those acting on its behalf, the authorization to:
Record all students' participation and appearance on video media, audio media, film, photograph, livestreaming, or any other medium.
Record all students' work, including musical compositions, on video media, audio media, film, photograph, livestreaming or any other medium.
Use all students' names, likenesses, voices, and biographical materials in connection with these recordings.
Exhibit or distribute such recordings in whole or in part, without restrictions or limitations, for any educational or promotional purpose which Longy School of Music of Bard College and those acting on its behalf deem appropriate.
Students who may have commitments to any other person or entity which would conflict with the rights granted above are responsible for informing the school in writing of these relationships at the time of registration.
You agree that all rights in and to any and all recordings made of student's performances at Longy School of Music of Bard College, including all video media, audio media, film and photographs, shall be owned exclusively by Longy School of Music of Bard College.
I consent to the audio and image recording policy.
Parent/Legal Guardian Information
Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Email
*
First Student Registered
*
Is this the first student you are registering for Longy's Summer Academy, 2022?
Yes
No (I have already provided emergency contact information for this family)
Cell Phone
Text OK?
May we use the number above to communicate via text messages?
Yes
No
Home Phone
Work Phone
Primary Language
Amharic
Arabic
Armenian
Bengali
Cajun
Chinese
Croatian
Czech
Danish
Dutch
English
Finnish
Formosan
French
French Creole
German
Greek
Gujarathi
Hebrew
Hindi (urdu)
Hungarian
Ilocano
Italian
Japanese
Korean
Kru
Lithuanian
Malayalam
Miao (hmong)
Mon-khmer (cambodian)
Navaho
Norwegian
Panjabi
Pennsylvania Dutch
Persian
Polish
Portuguese
Rumanian
Russian
Samoan
Serbocroatian
Slovak
Spanish
Swedish
Syriac
Tagalog
Thai (laotian)
Turkish
Ukrainian
Vietnamese
Yiddish
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Second Parent/Legal Guardian Contact Information
*
Would you like to enter information for another parent or legal guardian?
Yes
No
Parent/Legal Guardian 2 Contact Information
Name
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Cell Phone
Ok to Text
Is it OK to text the number above with information about the Side-by-Side Season, reminders, and updates?
Yes
No
Home Phone
Work Phone
Email
Primary Language
Amharic
Arabic
Armenian
Bengali
Cajun
Chinese
Croatian
Czech
Danish
Dutch
English
Finnish
Formosan
French
French Creole
German
Greek
Gujarathi
Hebrew
Hindi (urdu)
Hungarian
Ilocano
Italian
Japanese
Korean
Kru
Lithuanian
Malayalam
Miao (hmong)
Mon-khmer (cambodian)
Navaho
Norwegian
Panjabi
Pennsylvania Dutch
Persian
Polish
Portuguese
Rumanian
Russian
Samoan
Serbocroatian
Slovak
Spanish
Swedish
Syriac
Tagalog
Thai (laotian)
Turkish
Ukrainian
Vietnamese
Yiddish
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Non-Parent Emergency Contact (NPEC)
Please provide contact information for one non-parent/legal guardian emergency. This person will only be contacted once all other parental contact information has been tried.
Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Relation of NPEC to Student
*
Primary Phone
*
Secondary Phone
Comments
This field is for validation purposes and should be left unchanged.
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