TCCSA - Summer Camp Registration
Student Name
*
First Name
Last Name
Camp Desired (mark all that apply):
Children’s Summer Theater (Music and Drama - entering 1st grade through 9th grade): May 28-June 8 *two-week camp ($345.00)
Imagine Arts (all ages): June 3-7 ($180.00)
Band Camp (entering 4th grade through 12th grade): June 10-15 ($180.00)
Summer Piano Expedition (entering 1st grade through 12th grade): June 17-22 ($180.00)
Lift Your Voice! (Choral/Vocal – entering 4th grade through 12th grade): June 25 – 29 ($180.00)
Parent Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
*
example@example.com
Emergency Contact Name (If different from parent)
*
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Previous years of study
Current Teacher
Teacher Email Address
example@example.com
Please list any relevant recent musical experiences (performances, competitions, pieces studied, etc.):
T-shirt Size
Please Select
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Count Workshops
Fee Calculation
TCCSA Registration Fee
*
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USD
TCCSA Payment
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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