REGISTRATION FORM SUMMER CAMP | Sound and Stage Academy

Student First and Last Name

Student's Birthday

Month

Day

Year

First name (Parent/Guardian)

Last name (Parent Guardian)

Phone

Emergency Contact Name

Emergency Contact Phone Number

Medical Conditions

The safety of your child is our number one priority. It is vital that we are aware of any medical conditions such as asthma, heart conditions, diabetes, allergies, etc... Please include any medications or medical devices your child may bring (such as an inhaler or epi pen).

Additional information:

Please let us know if there is any additional information you believe would be helpful for staff to know ahead of time, assistive devices, or accommodations your child may need.

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