Summer Camp 2025 Registration

Summer Music Camp Registration

Enrollment is limited, and is on first come first serve basis. Once we are full you will be notified about waitlist options. *** WEEK ONE IS NOW FULL, PLEASE SIGN UP FOR WEEK 2, OR EMAIL TIFFANY@PACIFICSCHOOLOFMUSIC.ORG FOR WAITLIST OPTIONS***
Welcome to registration for Pacific School of Music Summer Camps! This year we are offering two weeks of Rock Camp. Each will culminate in a concert the last day. Camp times are 9am-3pm. Located on the Pacific School of Music campus within Silverlake Presbyterian Church (no affiliation), 2930 Hyperion Ave. in Silverlake

Rock camp is based around rock instuments: drums, guitar, bass, and keyboard, but other instuments are welcome as well! No experience necessary, we will have instuments for you to use unless you prefer your own.

Come have fun, join a band, and write and perform your own song!
Which Camp are you registering for, or Rock Ramp June 23-27th or Rock Camp July 7th-11th? (please register separately if attending both weeks)*
Do you have experience playing an instrument? Which one(s)
How many years experience for each one?
Anything else you want to let us know about your musical history?
Student Information
Student's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade COMPLETED in May 2025*

2nd Grade3rd Grade4th Grade5th Grade6th Grade
What School does your child attend?*
Friends or Sibling's Name ATTENDING Camp (optional)

First NameLast Name
For Rock Camp participants, please put these options in the order of preference, we will try to get as many kids as possible their first or second choice: Guitar, Bass, Drums, Keys, or Singing only
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*

Area CodePhone Number
E-mail*
Confirm E-mail*
example@example.com
Emergency Information Other than the name listed above
Emergency Contact's Name*

First NameLast Name
Relationship*
Secondary Emergency Contact Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Any allergies or other health concerns we should be aware of?
Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Pacific School of Music during the selected camp. Pacific School of Music is not responsible for increased mental capacity and grades in school. However, we do guarantee providing each student with fun developmentally appropriate tasks, strategic lessons, and researched based content to that is known to elevate confidence and focus in a way that only music can!
Liability Waiver While we never anticiapte anyting happening, and we are always looking out for the safety of the children, we live in a world where liability release and waiver is necessary. By signing this form you are releasing, discharge, covenant not to sue and hold harmless Pacific School of Music and employees. You are assmuning an express voluntary assumption of risk, traveling to or from, and during the camp.
Media Disclosure Pacific School of Music may periodically photograph students participating and working during camp. These photographs may be used in a variety of ways; Public relations and marketing purposes: images printed on brochures, posters, and newsletters, or on the Pacific Schoool Website, Facebook/Instagram Page, and/or other art, education, or news related publications. Please indicate whether you will allow publication of photographs taken of your child/children and their literacy work during classes. Names will not be included in photographs or posted on social media. We appreciate your support and would love the chance to share pictures of all of the fun being had at our Summer Camp. You can also follow us on Facebook and Instagram to capture all of the pictures yourself!
Can we use images of student while at camp?
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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Total cost of camp is $525, for 9am-3pm. A deposit of $100 is required to reserve your spot, or you may pay the full tuition up front.

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Camp Registration Deposit, Balance due before first day of class (non-refundable)

$100.00

Full tuition payment Tuition is non-refundable but may be used for credit in case of illness

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Summer Music Camp Registration

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