Music & Arts Camp 2017 Registration Form
Please complete the information below for Music & Arts Camp at First Christian Church (Disciples of Christ), Albany, OR. To complete registration, mail or bring $5 per child ($10 for families with more than one child) to the church office (432 Ferry St. SW, Albany, OR 97321). If you have questions, please contact 541-926-8606 or email
fccrevda@gmail.com
. If you are registering multiple children, please complete the form for each child.
* Required
Email address
*
Your email
Name of Child
*
Your answer
Age
*
Your answer
Grade just completed
*
Pre-K
Kindergartern
1st
2nd
3rd
4th
Other:
Child T-Shirt Size
*
Your answer
Allergies
*
Your answer
Any previous music & arts experience?
*
Your answer
Parent(s) Name(s)
*
Your answer
Parent(s) email(s)
*
Your answer
Best Contact Phone #
*
Your answer
Address
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone #
*
Your answer
Emergency Contact Relationship to Child
*
Your answer
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