Personal Information

Summer Music Camp

Lakeshore Trinity United Church, Pointe-Claire
FILL ALL THE INFORMATION

Camp Registration and Payment
Name*

First NameLast Name
Cell Number*

Area CodePhone Number
Email*
example@example.com
Age*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Grade in Fall*
Gender*
Instrument*
Application Completed by*
Parent Name*
Parent Email*

Which week are you attending?*
Any allergies?*
Permission to go to the park*
Who is authorized to pick the kid up?*
I authorize taking pictures of my kid and sharing them on social media.*

Payment Review
Payment Via Interac Your payment is confirmed once you made it via Interac to the email: juliavaleropiano@gmail.com

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