Keyboard Adventures: Summer Registration Form

Parent/ Guardian Last Name:

Parent/ Guardian First Name:

Child's Full Name:

Home Phone:

Emergency/ Cell Phone:

E-Mail:

Select the items you are registering for:

Please select ALL that apply. See camp descriptions at right.

Pee-Wee Piano (ages 5 - 6)

$100, limit 6

High-Tech Music Creation (various age groups, see below)

$100, limit 6

Songwriter Camp (various age groups, see below)

$100, limit 6

Accompanist Training

$125, limit 6

Musical Theatre Pianist Camp - Smokey Joe's Cafe

$200, limit 5

*see camp descriptions for exact dates

6-Pack Private Piano Lessons

* two per week may be scheduled if you are away a lot.

If you registered ONLY for camps, and have not registered for private lessons, you are finished. Please hit submit below (scroll down).

If you did register for a 6-pack of private lessons, please select your first and second choice time block during July and August. It should be a time that you are comfortable continuing into the school year. You will see that my teaching schedule has changed a bit from the present lesson schedule.

My first choice time: My second choice time:

If you have any additional comments on which times you prefer, please

enter them below.

You are finished! PLEASE HIT SUBMIT TO COMPLETE YOUR REGISTRATION.