2011 Elementary Music & Arts Camp Registration

* Child's Name
* Date of Birth
* Grade Completed
* Parent(s)'/Guardian(s)' names:
Father's cell phone
Mother's cell phone
* Address
* City
* Zip Code
* Home Phone
* E-mail
* First Emergency Contact Name
* First Emergency Contact Phone
* Second Emergency Contact Name
* Second Emergency Contact Phone
* Physician to call in emergency
* Phone
* Person(s) authorized to pick up child
* Phone
* Allergies/special needs of child
* T-shirt size
Elective choice (4th and 5th graders only)
* I hereby give my consent for my child to participate in all camp activities
 


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