Rock U 1 Questionnaire Student Info Name*: Address*: City*: Zip*: Parent’s Phone*: Your Phone: Parent’s Email*: Your Email: What camp are you enrolled in?* Select a campSan Francisco CampsRock U 1: June 19-23 (grades 6-8) Rock U 1: July 24-28 (grades 6-8) What’s your instrument? Choose instrumentGuitarBassDrumsKeysVoiceOther How long have you been playing? Do you play any other instruments? Do you write songs? Do you sing? Can you read a chord chart? Can you read a tab chart? Can you read standard notation? Can you solo (play lead)? Have you played on stage? Do you have a band? Name three songs you can already play: Pick a song from the list that you’d like to play in camp: Choose a songTore Down – Freddie King / Eric ClaptonHoochie Coochie Man – Muddy WatersRed House – Jimi HendrixMannish Boy – Muddy WatersW-O-M-A-N – Etta JamesBorn Under A Bad Sign – Albert King / CreamThe Sky is Crying – Albert King / Stevie Ray VaughnSoul Man – Sam and DaveI Feel Good – James BrownPlay That Funky Music White Boy – Wild CherryMr. Big Stuff Jean KnightSittin on the Dock of the Bay – Otis ReddingRespect – Aretha Franklin / Otis ReddingChain of Fools – Aretha FranklinHigher Ground – Stevie WonderStir It Up – Bob MarleyKnock On Wood – Otis Redding Name a song (with artist) you would like to play in camp: Summer Camps Questionnaire: Rock U 1 Please submit this form at least one week in advance of your camp in order for us to best plan. Thank you!