2017 Summer Camp Registration Form

2017 Summer Music Camp Registration
Parent/Guardian Name *

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Are you the primary contact? *

Yes No
Number of Campers you want to register *

Complete the following if you are not the primary contact
Primary contact for Child *

First Name Last Name
Primary contact phone number *

Area Code Phone Number
Primary contact email *

Emergency Contact Information (Required)
Emergency Contact *

First Name Last Name
Emergency Contact Phone Number *

Area Code Phone Number

Please fill out each child's information and select which camps they are attending. Be sure to double check for accuracy.

*camper requires some music experience, for details refer to summer camp options

**music experience and part 1 of camp are required, for details refer to summer camp options.

My Camps *

Total Camps $ 30.00 CAD

Quantity

Enter coupon

Total $ 0.00 CAD

Coupon Codes:

Registering for 3-5 camps, use: camps3-5

Registering for 6+ camps, use: camps6+

*online payment is not integrated with this form, please enter the number of camps and enter the coupon code so you know the total cost of camps. You will be contacted shortly with payment methods for cheque or e-transfer
Should be Empty: