Camp Registration

Summer Camp Registration

Please complete the form below to register for summer camp.

Student Name *

Birthdate *

Year

Month

Day

Gender *

Male

Female

Parent Name *

Street Address *

City *

State *

Zip code *

E-mail *

Home Phone *

e.g. 920-832-6632

Cell Phone

e.g. 920-832-6632

Grade Fall 2013 * Grade

Summer Camp *

Repertoire

Music Teacher

Instrument

Roommate request

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