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St. Andrew Summer Music Camp Registration Form
About the Camp Classes will be July 13-17, 2009 from 9:30am-12:30pm. Parents and friends are invited to the guest performances on Tuesday and Thursday from 12pm-12:30pm. A final Celebration Potluck and Concert Performance will be held on Sunday, July 19 at 11:30am.
Enrollment Cost Please send this completed form and $25 per child / $35 per family to St. Andrew Church, 9850 Monroe Ave, Aptos, CA 95003. For more information call us at (831) 688-4211 or email dkadkins@sbcglobal.net.
Youth’s Name_________________________________________Grade______School________________________Age______
Address_____________________________________________________________E-mail______________________________
Parent(s) Name(s)_________________________________________Day Phone #_____________________________________
Emergency Contact________________________________________ Phone #________________________________________
Please list medications and/or food allergies : _________________________________________________________________
In case of medical emergency, the Summer Music Camp at St. Andrew personnel are authorized to take my child to the hospital for emergency care including x-rays and surgery. I will not hold the St. Andrew Presbyterian Church or its agents liable.
Physician ________________________________________ Phone #________________________________
Insurance Carrier ________________________________________ Policy # _________________________
Parent’s Signature _________________________________________ Date __________________________
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