| CONTACT INFORMATION |
| Name |
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| Age |
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| Sex |
M F |
| School |
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Grade
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| Years on Team |
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| Address |
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| City, State Zip |
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| Phone |
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| Email |
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| CAMP INFORMATION - Pick three of the following classes |
I WILL BE ATTENDING THE MUSIC 'N MOTION SUMMER TOUR FOR INSTRUCTION IN *Master Classes offered only at Orlando Camp |
| FLAG CLASSES
|
RIFLE CLASSES
|
SABRE CLASSES
|
DANCE CLASSES
|
| I WILL ATTEND THE FOLLOWING CAMP |
|
| I CHOOSE THE FOLLOWING OPTION ON MY CAMPER STATUS |
DAY CAMPERS $109
INSTRUCTION ONLY |
DAY CAMPERS W / MEALS $149
INSTRUCTION, PLUS 2 LUNCHES, 2 DINNERS, CAMP T-SHIRT AND LANYARD |
OVERNIGHT CAMPERS $249
INSTRUCTION
2 LUNCHES, 2 DINNERS, CAMP T-SHIRT AND LANYARD . . . PLUS 2 HOT BREAKFASTS AND 2 NIGHTS HOTEL STAY |
$39
CAMP T-SHIRT & LUNCH (Only for HARDEE HIGH SCHOOL CAMP) |
| SELECT T-SHIRT SIZE |
S - M - L - XL - XXL |
| SPONSORS ARE ENCOURAGED TO ATTEND CLASSES AND WELCOME TO ATTEND FREE AS DAY CAMPERS OR ADD MEAL COSTS ($40) OR OVERNIGHT COSTS ($179) AS CHAPERONES. TEAMS OF OVER 10 RECEIVE A $10 DOLLAR PER MEMBER DISCOUNT WHEN PAID WITH A SCHOOL
CHECK BY OUR DEADLINE OF JUNE 1ST. A $50 NON-REFUNDABLE DEPOSIT IS REQUIRED WITH EACH REGISTRATION. |
| MEDICAL INFORMATION |
| Health Insurance Company |
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| Policy Number |
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| Group
Number |
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| Emergency Contact |
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| Phone |
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| Current
Medications, Allergies |
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| CONSENT |
| I give my child permission to attend
and participate in the Music 'n Motion Performance
Camp and release the director and instructors from
all liability in case of accident. I hereby authorize
Music 'n Motion to authorize and obtain medical treatment
for my child named above in this registration form. |
| Agreement |
Click here to agree with the above statement. |
| Submission |
|