Music Camp Registration
Please fill out one form for each child.

Dates/Times:  Monday - Friday, July 11-15, 9:15 AM - 12 Noon, AND a performance on that Friday at 6:30 PM
For:  Children who are 4 years old - 5th Grade
Event Address:  Rothwell Baptist Church, 216 Rothwell Street, Pooler GA 31322
Questions?  Contact us at or 912-748-7593

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Email *
Child's First & Last Name & Age *
Child's Grownup's Name & Phone Number *
Alternate Emergency Contact:  Name & Phone Number *
Address *
Does this child have any allergies?  If so, please list them below. *
May we share kind photos of your children on our social media channels?
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A copy of your responses will be emailed to the address you provided.
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