Psalmie Music Axademy

Child's Name:

First NameLast Name
Birth Date:

MonthDayYear
Age:
Gender
Gender
Grade Completed:
Parent/Gardian:

First NameLast Name
Parent’s Mobile Number :
Format: (000) 000-0000-0000.
Home Address:
E-mail:
example@example.com
Instrument of Choice
Previous Musical Experience
Who is Picking up Your Child:
Emergency Phone Number :
Format: (000) 000-0000-0000.
Additional comments:
Parental Consent

☐ I confirm that the information provided is correct, and I give permission for my child to participate in the Creative Sounds Summer Camp 2026.

My child's picture can be used for promotional content on Social Media platforms, website and Newsletters.
Child's Name of Consent:

First NameLast Name
Parent's Name:

First NameLast Name
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
By submitting this form, I give consent to Psalmie Music Academy of the child above
Should be Empty: