Blast Off with Piano Camp
Use this form to sign up for the 2026 Blast Off with Piano Camp by June 1st! One form per camper; those with multiple campers will need to fill out multiple forms. This camp has camper limits (6 campers per class), you will receive an email confirmation when our sign ups are finalized. Full payment is required in advance to hold your spot (check or Venmo accepted). Fees are not refundable unless the camp is cancelled by the teacher; however, enrollment may be transferred to another camp if space is available.
Parent's Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Camper's Name
First Name
Last Name
Camper's Age
Date of Birth
Gender
Grade Entering
School
How did you hear about our Blast Off with Piano Camp?
Please Select
Website
Social Media
Newspaper
Poster / Flyer
School
Friend
Other
Is there anything we should know about your Camper that would be helpful to best meet their needs? (allergies, health, behavioral, if no please type N/A)
Please check the box for the camp you are attending. Camp Registration: $215 per student
Blast Off with Piano Camp (Grades K-1st) -> July 6 - July 10 from 11:00am-12:00pm
Blast Off with Piano Camp (Grades 2nd-5th) -> July 13 - July 17 from 11:00am-12:00pm
Payment Method
Check (Mail to Michelle's Musical Keys, 217 1st St., Kalona, IA 52247)
Venmo @Michelle-Vincent-40
Submit
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