Jam Camp 2018 Registration
Please fill out this form to register for Jam Camp with Wendy Lanxner.
Camper Information
Camper name
Your answer
Age
Your answer
Camper cell phone
Your answer
Camper email
Your answer
Camper home address
Your answer
Do you play an instrument?
If yes, what do you play, and are you beginner, intermediate or advanced?
Your answer
What instrument(s) would you like to play at camp?
Your answer
Do you like to sing?
Who are some of your favorite artists and/or bands?
Your answer
Caregiver Information
Please indicate week(s) you would be able to attend (weeks to be organized based on age & skill level):
Caregiver 1 Name
Your answer
Address (if different from camper)
Your answer
Caregiver 1 Email
Your answer
Caregiver 1 Cell phone
Your answer
Caregiver 2 Name
Your answer
Caregiver 2 Email
Your answer
Caregiver 2 Cell phone
Your answer
Emergency contact name and cell phone:
Your answer
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