Summer Camp Registration
Please complete the form below to register your child for summer camp.
Student Name
First Name
Last Name
Student Date of Birth
-
Month
-
Day
Year
Date
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Emergency Contact Name (Must be different from parent/guardian above)
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
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Camp Selection
Please make your camp selection and payment below.
Camps
*
Categories:
All
All
Rochester Summer Camps
Oxford Summer Camps
Royal Oak Summer Camps
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Rochester Summer Camps
Rock Band Camp (Lake Orion)
JULY 20-24 - 9am-4:30pm (before/aftercare available, please ask): *Note* This camp takes place off campus at 550 E. Silverbell Road, Lake Orion. Ages 6-12.
$
499.00
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Pop Piano Camp (Rochester)
JULY 27-31 - 1-4:30 Daily (can be taken with Singer Songwriter for full day option). Ages 6-12.
$
309.00
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Singer Songwriter Camp (Rochester)
JULY 27-31 - 9am-12:30 Daily (can be taken with Pop Piano for full day option). Ages 6-12.
$
309.00
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Bluey Piano Camp (Rochester)
AUGUST 3-7 - 9-11:30am - Ages 3-6. *Students must be bathroom independent to enroll*
$
219.00
Oxford Summer Camps
Rock Band Camp (Lake Orion)
JULY 20-24 - 9am-4:30pm (before/aftercare available, please ask): *Note* This camp takes place off campus at 550 E. Silverbell Road, Lake Orion. Ages 6-12.
$
499.00
Quantity
1
2
3
4
5
6
7
8
9
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Music Safari Camp (Oxford)
AUG. 3-7 - 9-11:30am Ages 3-6 *Students must be bathroom independent to enroll*
$
219.00
Pop Piano Camp (Oxford)
AUGUST 10-15 - 1-4:30pm - Ages 6-12 (can be taken with Singer Songwriter from 9-12:30 for full day camp)
$
309.00
Quantity
1
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Singer Songwriter Camp (Oxford)
AUGUST 10-15 - 9-12:30 - Ages 6-12 (can be taken with Pop Piano camp from 1-4:30pm)
$
309.00
Quantity
1
2
3
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Bluey Piano Camp (Oxford)
AUGUST 3-7 - 9-11:30am - Ages 3-6. *Students must be bathroom independent to enroll*
$
219.00
Royal Oak Summer Camps
Singer Songwriter Camp (Royal Oak)
AUGUST 3-7 - 9-12:30 - Ages 6-12 (can be taken with Pop Piano camp from 1-4:30pm)
$
309.00
Quantity
1
2
3
4
5
6
7
8
9
10
Music Safari Camp (Royal Oak)
AUGUST 10-15 - 9-11:30am - Ages 3-6 *Students must be bathroom independent to enroll*
$
219.00
Pop Piano Camp (Royal Oak)
AUGUST 3-7 - 1-4:30 Daily (can be taken with Singer Songwriter for full day option). Ages 6-12.
$
309.00
Quantity
1
2
3
4
5
6
7
8
9
10
Bluey Piano Camp (Royal Oak)
AUGUST 3-7 - 9-11:30am - Ages 3-6. *Students must be bathroom independent to enroll*
$
219.00
Payment Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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Student Information
Does your child have any allergies?
Yes
No
If yes, please explain:
Does your child have any medical, emotional, or behavioral conditions we should be aware of?
Yes
No
If yes, please explain:
Anxiety
ADD/ADHD
OCD
Asthma
Autism spectrum support needs
Seizure disorder
Other
Does your child take any medication that will need to be taken during camp? (please note, if yes, a separate medication informations form will need to be submitted).
Yes
No
Please list the names of those who have permission to pick your camper up from camp, and their relationship to your camper:
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I understand that photos and videos may be taken during camp activities, and I give permission for my child to be included in studio photos and videos used for promotional purposes.
Yes
No
Signature
I certify that the information provided above is accurate to the best of my knowledge. I understand that participation involves inherent risks, and I agree to hold harmless Red Piano Music Studio, its staff, volunteers, and employees from liability for injuries that may occur. I also understand that no refunds will be issued within 10 days of the camp start date.
Signature
Should be Empty: