Music Blast Camp!  
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Music Blast Camp!
We are one month away from Music Blast Camp!  A few important details below.  Please read these details and then complete this registration form by June 1 to hold your child's spot in the camp.  Can't wait to explore music together through bucket drumming, fun outdoor games, water xylophone melodies, music alphabet towers, and more!  I'm so excited!

***Please complete this form on a computer or tablet, NOT on a phone.  We are unsure of the reason but forms completed on phones do not get submitted correctly.  Thank you for your understanding and patience.

Dates:  Tuesday June 20-Thursday June 22
Time:  1-3pm each day
Where:  2748 Northwynde Passage, Sun Prairie, WI 53590
What to bring:  water bottle, sunscreen, swimsuit, and towel (depending on the weather!)
Tuition:  Payment of $80 due June 5 - please write checks to Cindy Terhune.  Mail or drop-off payment:  2748 Northwynde Passage, Sun Prairie, WI 53590.  Thank you!!!

Teachers:  Cindy Terhune and Ian Melrose (husband and music teacher at Cardinal Heights Upper Middle School)

Student Name *
Student Age *
School *
Completed Grade *
Parent/Guardian #1 Name *
Parent/Guardian #1 Phone Number *
Parent/Guardian #2 Name
Parent/Guardian #2 Phone Number
Emergency Contact Name *
Emergency Contact Phone Number *
Student Allergies and/or Health Concerns *
Has your child taken private or group music lessons?  If yes, please list the instrument studied or type of class (i.e. piano or Kindermusik) *
What kind of music does your child like to listen to? *
Anything you would like me to know about your child in advance of the camp?  (i.e. personality traits, special interests, learning style)  I'm so excited to explore music with your child this summer!! *
Terhune Music Studio Media Release:  Photos, videos, and audio recordings of students growing as musicians may be used by the teacher for promotional materials, TerhuneMusicStudio.com, the Terhune Music Studio Facebook page, teaching examples for colleagues, and studio newsletters.  I give permission for you to use:   *
I understand that tuition should be mailed or dropped off by Monday June 5 and is non-refundable.   *
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