spring break camp

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 22-26Session 2: May 30 - June 2Session 3: June 5-16Session 4: June 19-30Session 5: July 3-7Session 6: July 10-21Session 7: July 24 - August 4Session 8: August 7-11

Instrument(s) of choice:

guitarbassdrumspianovoice

What is your child's experience level on his/her instrument?

Gender:
malefemale

Date of birth:

School attending:

Your Child's Grade in Fall 2017

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

How did you hear about us?

Additional request

Promo Code:

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

 

To Sign Up for After Camp Care, please click HERE