2025 Teen Music Summer Camp Application Form

SO YOU WANT YOUR NAME IN LIGHTS

Music Summer Camp 2025 APPLICATION (AGES 12-17)
SUMMER CAMP DATES

MONDAY, JUNE 2ND - FRIDAY, JULY 11TH 2025

9:00 AM - 3:00 PM

WASHINGTON SHORES CHURCH OF CHRIST - ELLIS HALL

2818 Orange Center Blvd, Orlando, Florida 32805
Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
Email
example@example.com
Phone Number
Mobile Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School / Organization
Camper T-shirt size (shirts are in adult sizes)

SMLXLXXLXXXL
CAMP FEES

$50 ADMIN/APPLICATION FEE **NO Cost for 6-Week Camp Activities ** (Breakfast & Lunch is Provided)

Medical Information
Does the camper have any medical problems (allergies, seizures, headaches, etc)?
Please explain on the field provided
Is the camper currently under medication?
Please provide the details, the name of the medication and period of intake
Contact Information in Case of Emergency
Name

First NameLast Name
Contact Number

Area CodePhone Number
Relation to camper
Name

First NameLast Name
Contact Number

Area CodePhone Number
Relation to camper

WAIVER AGREEMENT

SUMMER CAMP RULES
SYWYNIL Music Summer Camp Rules & Regulations 2025
Signature of applicant or guardian representative (18 or Older)

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SO YOU WANT YOUR NAME IN LIGHTS