Community Of Hope Music Camp 2018 Registration Form

"Community Of Hope Music Camp 2018"

Register your Child for our Music School in the form below
Full Name Of the 1st Child*

PrefixFirst NameLast Name
Grade Level

Elementary SchoolMiddle SchoolHigh School
First Choice of Instrument

PianoDrumsGuitarDanceVocal
Second Choice of Instrument

PianoDrumsGuitarDanceVocal
Full Name Of the 2nd Child

First NameLast Name
Grade Level

Elementary SchoolMiddle SchoolHigh School
First Choice of Instrument

PianoDrumsGuitarDanceVocal
Second Choice of Instrument

PianoDrumsGuitarDanceVocal
Full Name of the 3rd Child

First NameLast Name
Grade Level

Elementary SchoolMiddle SchoolHigh School
First Choice of Instrument

PianoDrumsGuitarDanceVocal
Second Choice of Instrument

PianoDrumsGuitarDanceVocal
Full Name of the 4rd Child

First NameLast Name
Grade Level

Elementary SchoolMiddle SchoolHigh School
First Choice of Instrument

PianoDrumsGuitarDanceVocal
Second Choice of Instrument

PianoDrumsGuitarDanceVocal
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mother's Name
Email
example@example.com
Phone Number

Area CodePhone Number
Father's Name
Email
example@example.com
Phone Number*

Area CodePhone Number
Emergency Contact

First NameLast Name
Phone Number

Area CodePhone Number
Emergency Contact

First NameLast Name
Phone Number

Area CodePhone Number
Food Allergies/ Medication
How did you Hear about Us?
Comments

Music Camp Cost

Fee For the 1st Person$60.00

Fee For the 2nd Family Member$40.00

Fee For the 3th Family Member$40.00

Fee For the 4th Family Member$40.00

Total $0.00

"Community Of Hope Music Camp 2018"