Summer Camp Registration Form

Summer Camp Registration Form

Register your child for our exciting summer camp! Please provide accurate information below.
PAYMENT VIA INTERAC

Your registration is confirmed once you made the payment via Interac to the email: CONTACT@MUSICMASTERACADEMY.COM
Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Does your child have any allergies or medical conditions? If yes, please specify.
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name (if different from parent/guardian)

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Instrument Selection
In case your child wishes to do a different instrument each week, please specify below:
Which week(s) will your child attend?
Permission to go to the park
Who is authorized to pick up your child?
Do you authorize taking photos and video and sharing them on social media?
Should be Empty:

PAYMENT VIA INTERAC