Music and Arts Camp
at Lutheran Church of the Redeemer, Atlanta
Registration and payment
Please fill out one form per family. You will be able to submit payment with a credit card at the end of this form. Registration is not considered complete until your deposit has been paid. Once the registration form is submitted, you will receive an email confirmation. Welcome to Music & Arts Camp at Redeemer!
Child #1 name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date
Grade (Fall 2024)
*
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Select T-shirt size
*
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Child has experience with
choir
band
orchestra
theater
dance
piano
handbell choir
other instrument
Please explain: (list instrument played, years experience, school, church, camp, private lessons, etc.)
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Child #2 name
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Grade (Fall 2024)
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Select T-shirt size
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Child has experience with
choir
band
orchestra
theater
dance
piano
handbell choir
other instrument
Please explain: (list instrument played, years experience, school, church, camp, private lessons, etc.)
Back
Next
Save
Child #3 name
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Grade (Fall 2024)
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Select T-shirt size
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Child has experience with
choir
band
orchestra
theater
dance
piano
handbell choir
other instrument
Please explain: (list instrument played, years experience, school, church, camp, private lessons, etc.)
Back
Next
Save
Check if camper(s) will attend
Before Care 8:00-9:00 am
After Care 4:00-6:00 pm
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent Email
*
Phone Number during camp hours
*
-
Area Code
Phone Number
Emergency Contact #1
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Relationship
*
Emergency Contact #2
*
First Name
Last Name
Relationship
*
Phone Number
*
-
Area Code
Phone Number
Physician's Name
*
First Name
Last Name
Physician's Phone
*
-
Area Code
Phone Number
Medical Insurance Company
Insurance Policy #
Please list child's name and any of the following: medication allergies, food allergies, or chronic health concerns
*
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Save
Check to indicate your consent:
*
I understand that a 50% non-refundable deposit is due now, with the remaining balance due on or before June 10, 2024.
Check to indicate your consent:
*
I understand that no refunds will be given after June 3, 2024.
Check to indicate your consent:
*
In case of emergency I authorize camp staff to call 911, seek medical treatment and transport to the nearest hospital.
Check to indicate your consent:
*
I understand that I would be responsible for payment of any medical attention.
Check to indicate your consent:
*
I give my permission for my child to leave the Redeemer campus for a field trip in a passenger vehicle or bus.
Check to indicate your consent:
*
I understand that if there is a disciplinary problem that cannot be reolved, I may be contacted to pick up my child and asked not to return to camp.
Payment
My Products
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tuition deposit for one child
$
82.50
full tuition for one child
$
165.00
tuition deposit for two children
$
148.50
full tuition for two children
$
297.00
tuition deposit for 3 children
$
214.00
full tuition for three children
$
429.00
Total
$
0.00
Credit Card
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