ChiME Summer Camp Registration
Fill out this form to reserve your spot in ChiME's summer programming! Upon receipt of your completed form, we will reach out to confirm your enrollment and process payment. 

Bundle with ChiME! Register for multiple camps and receive a 20% discount on each additional camp (discount is applied towards the less expensive camps).
Sign in to Google to save your progress. Learn more
Student Full Name *
Student Birthday *
MM
/
DD
/
YYYY
Parent/Guardian Full Name *
Phone Number *
Email Address *
I would like to register for the following Summer programs *
Required
I would like to add before/after-care during the following weeks: 

Media Consent

Do you give ChiME permission to use photos of summer programs that include your child in promotional materials and posts, such as on the ChiME flyers, website, in email newsletters, and social media posts (we will NEVER list their names)?

*

How did you hear about us? 

 *
Required
Please let us know about any particular allergies or needs your child has or anything else we need to know to make their camp a success. 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ChiME - Chicago Center for Music Education. Report Abuse
Google Forms