2010 Elementary Music & Arts Camp Registration

* Child's Name
* Date of Birth
* Grade Completed
* Parent(s)'/Guardian(s)' names:
* Address
* City
* Zip Code
* Home Phone
Cell 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)
 


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