MADD Camp Registration
Music, Arts, Dance & Drama Camp
June 23-27
9 a.m. to 3* p.m. For children & youth ages 4-11 years
*4 & 5 year olds may opt to end their day at noon.
Please fill out separate registration forms for each child.
Child’s Name: ____________________________________________________________
Child’s Birth Date: ____________________ Grade entering Fall 2007: _______
Address: ________________________________________________________________
_________________________________ Phone: ________________________
Parent/Guardian’s Name(s): __________________________________________________
Work/Daytime Phone: ______________________________________________________
Additional Emergency Contact________________________________________________
T-Shirt Size (Child sizes):_________________ Is there anything else we should know about your child to help the week run more smoothly? Does your child have any special needs? _____
_______________________________________________________________________
_______________________________________________________________________
_____ $70 advance payment required for
Early Bird Rate before June 10.
$80 payment after June 10
_____ Total I will paying for this child
Will your child be able to participate in the Friday afternoon (5 PM) performance? ______
Medical Release Forms Information Sheet
