Student Information

Home Address

Private Instruction

Do you take private lessons?

Ensemble History

Have you played with LSYO before?
Have you played in any other ensembles?

Video Submission

Ensure you've followed our recording instructions (click here).  Upload your video to a service that will allow you to share a link to the file with us and paste the link in the field below.  Some recommendations include:

  • Google Drive (directions for uploading and sharing; ensure 'anyone with link' can access the file)

  • Dropbox (directions for uploading and sharing)

  • YouTube (directions for uploading; make sure it is marked as 'Unlisted')

Alternatively, you can use another service, just as long as you can obtain a shareable link to your video.

All students applying to the Institute are required to upload a video of their current solo piece or excerpt. While all students are accepted into the program, this will help with seating placement and programming for the Institute.

Emergency Contact

Medical Insurance Information

Policy Holder's Address



Is your child currently taking any medication?

If you are bringing medication(s) to camp, they will need to be given to the Camp Director in the morning to store.  Medication must be labeled and placed in a zip lock bag.  The student is responsible for locating the Camp Director to take medication.

Allergies/Medical Concerns

Does the student have allergies to food, medication, insect bites, plants or anything else about which we should be informed?  Does student have any history of medical/emotional problems (i.e. asthma, eating disorders, anxiety disorders, depression etc.)?  Please describe below.
Does the student carry an inhaler or epi-pen at all times?  Please describe below.

Medical Release

I give permission for my child to receive medical and emergency care during Camp and for a physician or other appropriate medical personnel to treat my child in a manner he/she thinks appropriate, in case of a medical emergency and/or a problem.  I authorize the chaperone (adult) to administer properly labeled over-the-counter medication that I may designate in writing.  Further, I permit my son/daughter to self-administer prescribed medications listed on this medical information form.  I agree that all medications shall be in original containers, and I waive the right to seek damages against the chaperone administering such medication.  I understand that I am responsible for the payment of all medical and emergency services rendered to my child.  I certify that the above information is complete and accurate to the best of my knowledge.  Misrepresented information or lack of information is grounds for immediate dismissal from the camp. 

COVID Policy

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Loudoun Symphony Youth Orchestra  (“LSYO”) has put in place preventative measures to reduce the spread of COVID-19; however, LSYO cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending in-person rehearsals could increase your risk and your child(ren)’s risk of contracting COVID-19.

By typing your name below, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.

Media Release

I authorize the Loudoun Symphony Youth Orchestra to allow videotaping/recording of all activities related to performances and rehearsals. The Loudoun Symphony Youth Orchestra has my consent to use video tapes/recordings or pictures of my child in rehearsals or performances for the purposes of training and teaching within the program as well as for promotional purposes for the Loudoun Symphony Youth Orchestra.

Check for required fields and resubmit. 

Masterclass Opt-In

Advanced violinists: Do you wish to be considered for Sunday's masterclass?

Your video submission should be a polished, performance-ready piece. If selected, this will be your masterclass selection. No substitutions are allowed. There will be a keyboard available if you need accompaniment.  Performers are expected to hire their own accompanist.