Personal Information

Emergency Contacts

Child will be released only to the custodial parent or legal guardian and the persons listed below. The following people will also be contacted and are authorized to remove the child from the facility in case of illness, accident or emergency if the custodial parent or legal guardian cannot be reached.
Emergency Contact 1:
First Name   Last Name
Area Code   Phone Number
Email
Emergency Contact 2:
First Name   Last Name
Area Code   Phone Number
Email
Emergency Contact 3:
First Name   Last Name
Area Code   Phone Number
Email

Medical Information

I hereby grant permission for the staff of this facility to contact the following medical personnel to obtain emergency medical care if needed:
Doctor:   First Name   Last Name
Doctor's Phone #:    Area CodePhone Number

Please list allergies, special medication or dietary needs, or other areas of concern:   Type a label

Music Rowe Studios Release Forms

All forms, deposits, and your child’s camp tuition must be turned in before the first day of camp. For supervised activities you must agree to release and discharge Music Rowe Studios, its employees, and volunteers accompanying exercising reasonable care; from liability growing out of personal injuries and property damage resulting or occurring during the camp activities.
Please complete and submit the following forms prior to your child's first day of camp. You may also bring a physical copy to camp. Your child will not be allowed to participate without the submission of these forms.
Upload Waiver and Release of liability here

Browse Files

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Upload Photo Use Release form here

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My signature indicates my understanding that I am responsible for dropping off my child by 9am and picking up my child no later than 12:15pm. My child will not be released to anyone who is not on their emergency contact list. Teenage drivers will be released to drive home if they are licensed. I will provide my child with any snacks they may need during camp hours. I acknowledge that each classroom has recording devices and the studio maintains the right to record attendees throughout the studio week. Discipline is the responsibility of the parents or guardians, and if bad behavior proves to be a continued problem with my child further action may be necessary.

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Identify the Camp(s) you would like to attend
Let's Get Writing June 12-16 9am-12pm Available to rising 6the graders and up
In The Studio June 19-23 9am-12pm Available to rising 6the graders and up
Get Your Music Heard June 26-30 9am-12pm Available to rising 6the graders and up
Full 3-week Experience June 12-16, 19-23, 26-30 Available to rising 6the graders and up

Payment Review
Let's Get Writing
In the Studio
Get Your Music Heard
3-week experience
Total Due
A receipt will be emailed to you upon submission.
Is your child a current student of Music Rowe Studios?

YesNo
Your account will be charged if your child is a current student. If your child is not a current student, please contact the studio at (904) 342-7659.

*Half of tuition costs ($100 per week attending) must be payed as a nonrefundable deposit to hold your spot in camp. We cannot guarantee a spot in camp without a deposit. By submitting this form, you are consenting to the deposit being charged to your account. Remaining tuition costs are due 3 weeks prior to the first day of camp

Summer Songwriting Camp