Summer Camp Enrollment Form

Your Child's Name (required)

Your Name (required)

Your Email (required)

Camp Session(s) (You can select multiple sessions.)
Session 1: May 18-22Session 2: May 26-29Session 3: June 1-12Session 4: June 15-26Session 5: June 29 - July 10Session 6: July 13-24Session 7: July 27 - August 7Session 8: August 10-14

Instrument(s) of choice:

guitarbassdrumspianovoice

What is your child's experience level on his/her instrument?
Beginner (0-2 years)Intermediate (3-5 years)Advanced (6 or more years)

Gender:
malefemaleother

Date of birth:

School attending:

Your Child's Grade in Fall 2020

Child's shirt size
Youth smallYouth mediumYouth largeAdult smallAdult mediumAdult large

Your home phone:

Your cell phone:

Your work phone:

Your Street Address

City

State

Zip Code

Aftercare:
YesNo

Aftercare Dates

How did you hear about us?
---Word of MouthFacebookGoogleCraigslistYelpYellow PagesInternet SearchPrint Ad

Additional request

Promo Code:

I grant STL Rock School permission to use either a photograph, video, or film image of my child for the promotion of Rock School. Promotional materials include STL Rock School web site, brochure, poster, or news related mediums.
yesno