Peace Music Camp
August 1-5, 2011   9AM - 12 Noon
REGISTRATION FORM
Registration Deadline is July 25, 2011


Name _________________________________________

Address _______________________________________

City__________________  State_____   Zip__________

Phone____________________    E-mail__________________________________

Age______    Grade (in Fall 2011)__________

Instrument/voice part_____________ Years of study____                                             Do you have your own music stand?_____

Please briefly describe your musical background (lessons, school ensembles, other music interests)

________________________________________________________________________________________________________________________________________________

Note: Music will be provided to Instrumental and Beginner Voice students. Advance Voice students; please bring solo music you are familiar with to the first day of camp.

Music teacher/director's name _______________________________________

Phone_____________      E-mail______________________________________

Parent's signature_________________________________________________

Parent's name printed______________________________________________

Emergency contact phone________________

Any allergies or special needs? ______________________________________________

Registration and Camp Costs $60 / $50 for Peace church members
(Payment must Accompany Registration Form)
Make checks payable to: “Peace Lutheran Church - Peace Music Camp”

Peace-Tohickon Lutheran Church
100 Old Bethlehem Road
Perkasie, PA   18944