EmailMe Form - Junior Stallion Music Camp Registration Form

Image

Camper Name

First Last

School & Grade Completed

Camper Age

Camper T-Shirt Size

Address

Street Address City State / Province / Region Postal / Zip Code

Parent/Guardian #1

First Last

Parent/Guardian #1 Email

Parent/Guardian #1 Phone

### - ### - ####

Relation To Camper

Parent/Guardian #2

First Last

Parent/Guardian #2 Email

Parent/Guardian #2 Phone

### - ### - ####

Relation To Camper

Camper Medical Information
Physician Name

Camper Medical Information
Physician Phone

### - ### - ####

Please list any medications your child is taking and any medical information that could be of use in the event of an emergency.

Please list any allergies to medications and/or food.

Please list any other medical information you would like for our camp staff to be made aware of.

Does your camper have any previous musical knowledge or experience? If so, please briefly describe.

Does your camper currently play an instrument? If so, please list the appropriate instruments.

Would you like to register your camper for a 30-minute daily applied lesson for voice or their chosen instrument?

Yes

No

If yes, please select ONE: