CAMPER INFORMATION *

First Name

Last Name

Choose Instrument Orientation *

Left-Handed

Right-Handed

PARENT/GUARDIAN INFORMATION *

First Name

Last Name

Phone *

(###)

###

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

UKULELE OPTIONS *

I will bring my own ukulele

I would like to rent a ukulele for $25

EMERGENCY CONTACT *

First Name

Last Name

Emergency Contact Phone *

(###)

###

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CONSENT *

I authorize the staff and volunteers of Jubilee United Church and Grove Music School to provide first aid and seek emergency medical care if necessary.


I give permission for photos or videos of my child to be taken during camp and used in future Grove Music School or Jubilee United Church promotional materials.