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 (7/11 – 7/22) _____________________ Enclosed Deposit_______________________

   Session II (8/8– 8/19) ___________________       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 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: ____________________________________________________________