REGISTER ONLINE
Band / Vocals
DO NOT REGISTER ON A TABLET OR A PHONE
USE A COMPUTER CONNECTED TO A PRINTER
YOU WILL BE REQUIRED TO PRINT AN INVOICE AFTER YOU REGISTER
WEEK ONE WAIT LIST
EMAIL latella@ptd.net to be on a wait list

Camper's Information
Campers Last Name:
Campers First Name:
Campers Address:
City:
State:
Zip:
Phone Number:
(please be sure this number is operational)
Parent's Cell Phone:
Parent's Email:
Verify Email:
Campers Age:
Campers  Date of Birth :
Campers Gender:
Grade You will enter NEXT School Year
Type of Registration:
* Children must be 9 - 17 years old to sleep over.
WEEK ONE HAS A WAIT LIST EMAIL latella@ptd.net

Would you be willing to make a monetary donation to camp beyond the registration fee ? If so please enter the amount. If not leave blank.
**** ABOUT INSTRUMENTS AND LESSONS ****
Please read carefully

The focus of camp 2017 will be on music and musicianship. Our instructors are all over 18, and have or are working toward a degree in music education. All instruments must be provided by the camper. Drummers must purchase a basic drum pad and sticks prior to camp. All campers are expected to play at least at a beginner level and have taken either group or private lessons. Due to lack of interest guitar and strings will not be offered this year.

 

Instrument: (primary instrument) If not listed, select other and note it in the comments
Level of musicianship:
Emergency Information
Emergency Contact 1 Name:
Emergency Contact 1 Phone:
Emergency Contact 1 Relationship to Camper:
Emergency Contact 2 Name:
Emergency Contact 2 Phone:
Emergency Contact 2 Relationship to Camper :
Emergency Contact 3 Name:
Emergency Contact 3 Phone :
Emergency Contact 3 Relationship to Camper :
Medical information that we should be aware of: ( Medical information will be seen by the camp nurse, counselors and director only)
If a child needs medication, we need to know the dosage and the times to administer the medicine. All medication will be administered by the camp nurse. The medication must be in the original container with the instructions clearly written on the bottle. The bottle must have the child's name printed on the label. Any medication must be given to the registration person upon check-in.
Skip if none
Food Allergies:
Skip if none
Can we administer Tylenol if necessary:
Can we administer IBUPROFEN if necessary:
Can we administer antacid if necessary:
In the event of a medical Emergency, and we can not reach you or your contacts, do we have your permission to have your child transported to the hospital :
Camper's Physician Name:
Camper's Physician Phone:
Camper's Parent (s) Name:
Is your child allowed to go swimming with the group:

Please tell us anything else about your child that we may need to know:

ONCE YOU CLICK SUBMIT AN INVOICE WILL BE CREATED PLEASE PRINT THE INVOICE AND REMIT YOUR PAYMENT ASAP