Bach Children's Choir Summer Music Camp 2018
July 16-20th, 9:00 a.m.-12:15 pm
Email address *
Camper First Name *
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Camper Last Name *
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Camper Date of Birth *
XX/XX/XXXX
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Grade in Fall 2018 *
Camper School *
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Camper T-shirt size *
Friend placement request
You may request one friend to be placed in the same group as your child. We will do our best to accommodate these requests but it is not guaranteed.
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Parent First Name *
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Parent Last Name *
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Street Address *
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City *
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Zip *
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Best Phone Number *
XXX-XXX-XXXX
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Type *
E-mail *
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How did you hear about our camp? *
Emergency Contact Name (other than parent listed) *
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Emergency Contact Phone *
XXX-XXX-XXXX
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Emergency Contact Relationship *
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Names of adults authorized to pick up child from camp:
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Does your child suffer from any condition or illness that will require special attention or medication? *
Will your child be bringing any medication with him/her? *
Is your child restricted from participating in any physical activities? *
If you indicated "Yes" to any of the above, please describe:
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Does your child have any allergies (food, medicines, plants or insects)?
*Please note--Members of BCC staff are not permitted to give medication to any student.
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As a parent/guardian of the applicant, I hereby accept the condition of enrollment and give permission for my child to participate in the Bach Children's Choir (BCC) 2018 Summer Music Camp. I agree to comply with all program rules and hereby remove the BCC from any and all liability for injury or damages incurred while involved in this program. I give permission to the BCC for my child to be photographed, recorded, or interviewed in any way that would reasonably portray programs or events of the BCC. The BCC retains rights to any photographs or recordings of the participants in the Music Camp to be used for publicity or advertising in both print form and on the internet. The BCC is a non-profit company registered in the State of California. *
I do further certify that I am of full legal capacity to execute the above authorization and release.
Comments:
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A copy of your responses will be emailed to the address you provided.
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