Name ________________________________________________________________________
Birthdate ____________________Grade in Fall ______________Age During Camp___________
Mother’s Name _________________________________________________________________
Father’s Name__________________________________________________________________
Phone (Home) __________________________________________________________________
Address _______________________________________________________________________
City __________________________________State _________________Zip________________
Mother’s Cell ___________________________________________________________________
Mother’s Work Number __________________________________________________________
Mother’s E-mail Address __________________________________________________________
Father’s Cell ___________________________________________________________________
Father’s Work Number ___________________________________________________________
Father’s E-mail Address __________________________________________________________
Session I (7/6 – 7/17) _____________________ Enclosed Deposit_________________________
Session II (8/3 – 8/14) ___________________ Enclosed Deposit_________________________
CAMP T-SHIRT IS INCLUDED IN YOUR CAMP FEE
Please circle size (or we’ll guess!)
Child Small Child Medium Child Large
Adult Small Adult Medium Adult Large Adult X-Large
A SONG TO WORK ON DURING CAMP
You will be called to set up an individual appointment to receive an age-appropriate audition song
with an accompaniment CD and sheet music.
BIOGRAPHICAL SKETCH
Years of experience:
Jazz ______ Tap ______ Ballet ______ Hip Hop ______ Voice ______ Drama _______
Studied with: ____________________________________________________________
