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Registration Form For
The Community Music School Teen Celtic Music Camp: Overnight Program

Teen's Name:

Birthday:

Phone:

E-mail:

Address:

Parent's Names:

Emergency Contact Name:
Phone Number:

Instrument:

Medical Information:

Food Considerations:


Please use the PayPal button on the previous page, or send your check or money order for $575 (Overnight Program) or $450 (Day Program) to:

Community Music School of Santa Cruz
P. O. Box 531 Santa Cruz, CA 95061
(831) 426-9155 phone and fax
e-mail: shelley@communitymusicschool.org