Date & Time
June 17, 2024 9:00 AM - 3:00 PM
14 out of 60 remaining tickets available
Type
Price
Quantity
Camper (Grades K-5th)
12 Remaining
Price
$30.00
Quantity
Youth Assistants (Grades 6th-12th)
2 Remaining
Price
$0.00
Quantity
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Camper (Grades K-5th)
0
2024 Summer Music Camp Registration Form
Please complete all required fields.
Youth's First Name
*
Youth's Last Name
*
Grade Entering in the Fall
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th-8th Grade
9th-12th Grade
Youth's Preferred Name
Date of Birth
*
Youth's Gender
Male
Female
Please indicate names of friends your youth would like to be grouped with, if any.
Youth T Shirt Size
*
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Home Address
*
Home City
*
Home State
*
Home Zip Code
*
Health History Information
Dietary Restrictions/Allergies
*
Does child carry an Epi-Pen?
Yes
No
N/A
Parent/Guardian Contact Info
Parent/Guardian #1 Name
*
Preferred Phone Number
*
Primary Email Address
*
Parent/Guardian #2 Name
Preferred Phone Number
Secondary Email Address
Emergency Contact Info (if different than above)
Emergency Contact Person
Emergency Contact Relationship to Child
Emergency Contact Phone #
Permissions
I am the lawful adult parent or guardian of above youth.
*
Yes
No
My youth has permission to take part in all activities of Youth Music Camp. I agree that Joy Lutheran Church and their personnel will not be held responsible for accidents arising therefrom.
*
Yes
No
I give Joy Lutheran Church personnel permission to seek medical treatment for my youth in case of injury or illness.
*
Yes
No
I give permission for photos, video, and electronic images to be taken of me and/or my youth and that they may be used by Joy Lutheran Church for promotional purposes.
*
Yes
No
Youth Assistants (Grades 6th-12th)
0
2024 Summer Music Camp Registration Form
Please complete all required fields.
Youth's First Name
*
Youth's Last Name
*
Grade Entering in the Fall
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th-8th Grade
9th-12th Grade
Youth's Preferred Name
Date of Birth
*
Youth's Gender
Male
Female
Please indicate names of friends your youth would like to be grouped with, if any.
Youth T Shirt Size
*
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Home Address
*
Home City
*
Home State
*
Home Zip Code
*
Health History Information
Dietary Restrictions/Allergies
*
Does child carry an Epi-Pen?
Yes
No
N/A
Parent/Guardian Contact Info
Parent/Guardian #1 Name
*
Preferred Phone Number
*
Primary Email Address
*
Parent/Guardian #2 Name
Preferred Phone Number
Secondary Email Address
Emergency Contact Info (if different than above)
Emergency Contact Person
Emergency Contact Relationship to Child
Emergency Contact Phone #
Permissions
I am the lawful adult parent or guardian of above youth.
*
Yes
No
My youth has permission to take part in all activities of Youth Music Camp. I agree that Joy Lutheran Church and their personnel will not be held responsible for accidents arising therefrom.
*
Yes
No
I give Joy Lutheran Church personnel permission to seek medical treatment for my youth in case of injury or illness.
*
Yes
No
I give permission for photos, video, and electronic images to be taken of me and/or my youth and that they may be used by Joy Lutheran Church for promotional purposes.
*
Yes
No
