2019 Music Preschool Summer Camp
Welcome to rayagrace! We are so happy to have your child join us for Music Preschool Summer Camp!

Your child will have fun learning about Dinosaurs and Outer Space mixed with Music and Academics! We have healthy snacks daily, dramatic play for developing social skills and speech, art and craft projects, and outdoor recess! Miss Cheri is an amazing teacher! Your child will love this!

Camp is June 17-28, Monday through Thursday, from 9:00-11:30 AM. The registration fee is $35 and
tuition is $100. For students ages 3.5-5.
Student's First and Last Name *
Put preferred name in parentheses if different
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Student's Gender
Birthdate *
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Parents' Names *
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Email Address *
Most important class information is communicated via email.
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Mailing Address *
Full address, including zip code
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Preferred Phone Number *
This number will be called first if we need to contact you during class.
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Secondary Phone Number *
Please note whose number this is.
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List any known allergies and health concerns or preferences. *
We would love to discuss meeting your dietary needs!
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Is there anything else we should know about your child or your registration?
Include other information, concerns, or requests here.
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Initial the box below to show agreement: Pick up and Drop Off *
I will park on the south side of the street or in the driveway. (The city requires that rayagrace patrons do not park on Canyon Road or on the north side of 3060 N.) I will drop my child off no earlier than 5 minutes before class. I will pick up my child within 5 minutes of the end of class. I will watch for other children when driving and will refrain from blocking the roadway or sidewalk. If I am late for pick up, I will call or message the teacher.
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Type your name in the box below to sign this release: Photographs *
I grant permission to Raya Grace LLC to use photographs and/or video of me and/or my child for use on the rayagrace website, Facebook page, and in email newsletters. Videos may be uploaded to YouTube. I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation on arising from or related to the use of the image. I maintain the right to request the discontinuation of any image or video.
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Type your name in the box below to sign this release: Liability Waiver *
Raya Grace Music Preschool and its teachers work hard to maintain a safe teaching environment, and have never had a problem with accidents; however, the rayagrace Music Preschool program does involve physical movement. There is also play equipment available during daily outdoor recess. By registering in this program, I, the parent or legal guardian, accept full financial liability for any accident or injury that could possibly happen to my child, myself, or any guest accompanying me, while in Raya Leavitt’s home or on her property and release Raya Grace LLC, Raya Leavitt, and all her heirs and connections, as well as all employees and their heirs and connections, from all liability.
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