Register
Music, Art, and Dance Camp 2019
 Sights and Sounds of  
SOUTH AMERICA!


     Parent(s) / Caregiver
 Student's Name (including preferred name)
    Age as of July 22
Birthdate
  Address
   Phone number
 Parent/Caregiver
 Alternate Phone
Parent/Caregiver
   E-mail
T-shirt size (shirts run small)
 How you heard about camp
  Any allergies or other medical  considerations
 Registration fee $25 PER FAMILY (non-refundable, immediate family only)
 Tuition $160 PER CAMPER  ($150 until 4/1)
Registration fee and Tuition $185 ($175 until 4/1)
You will be required to complete a medical information sheet, liability waiver, and photo release before the first day of camp.  These will be sent to you by email prior to camp.
Late Fee $10 (if received after 6/24)
 Alternately, you may send a check made payable to "Music, Art, & Dance Camp" to:
     Music, Art, & Dance Camp
     c/o Helen Haynes
           106 Chico Dr.
            Ashland, MO   65010

PLEASE INCLUDE CAMPER'S NAME ON "MEMO" LINE.
BE SURE TO SUBMIT YOUR FORM!  Look for a confirmation email.
NOTE:
If paying by paypal under a different name, please add a note with the camper's name, or send us an email at musicartanddancecamp@yahoo.com

I have read and agree with all financial and camp policies.