Summer Music Camp

During the two weeks of July 3-14 (excluding July 4!), Westminster Presbyterian Church will hold their second annual Summer Music Camp. The program has a choral emphasis, with campers having the opportunity to take elective classes in their choice of recorder playing, Orff instruments, drum circle, mariachi or handbells (exact selections will be based on camper interest). In addition, there will be daily classes in musicianship and sightsinging.

This year, the repertory will feature a medley from "Phantom of the Opera," plus a variety of other choral pieces. The concluding concert will be Friday evening, July 14 at 7:30 p.m., and will comprise both choral music and performances from the elective classes.

SUMMER MUSIC CAMP 2017 REGISTRATION

* Indicates required field

Name *

First

Last

Age and Grade Completed *

Musical Background *

Parent/Guardian *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Other adult who may pick up my child *

First

Last

Phone Number *

Medical Insurance & Policy # *

Food allergies/Medications *

Musical Elective *

MEDIA RELEASE
I hereby authorize Westminster Presbyterian Church (WPC) to take photos and videos during the event, which may later be used for marketing and promotional purposes. If you do not want pictures of yourself or your child appearing in any materials, please request in writing prior to the event.
CONSENT FOR EMERGENCY MEDICAL TREATMENT
In case of emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give the representative of WPC permission to act on my behalf to hospitalize, secure proper treatment and/or order an injection, anesthesia, or surgery for my child in the event that such treatment is deemed necessary by the physician, dentist, paramedic, EMT, or other skilled medical practitioner selected by the representatives of the WPC. I give permission to those administering emergency treatment to do so using those measures deemed necessary. I understand that I am signing for the minor listed on this form and my signature, as the parent or guardian of this minor, is consent for emergency medical treatment.
CONSENT TO PARTICIPATE
In planning and preparing for this event, WPC has carefully and methodically planned for a safe and successful event. However, no activity is without the possibility of hazards. Certain activities have inherent risks. Therefore, we want to alert parents, guardians and individuals to these risks. By signing this form, the parent, guardian and/or individual agrees to assume and accept all risks and hazards associated with its activity/event. These include, but are not limited to transportation to and from event location, transportation in and around the location of the scheduled activity/event, sports, health and safety hazards associated with sports activities and other unnamed and unspecified activities.
RELEASE OF LIABILITY (EXPRESSLY, SPECIFICALLY AND CONSPICUOUSLY INCLUDING NEGLIGENCE)
I further understand that BY signing below I AM FULLY AND FINALLY RELEASING WPC AND ALL ASSOCIATED PERSONS AND ENTITIES FROM ANY AND ALL claims and LIABILITY, EXPRESSLY INCLUDING BUT NOT LIMITED TO THEIR NEGLIGENCE, for any injuries, death, damages, or other losses that a participant may suffer or sustain in, before, during, or after events/activities contemplated in this document (or traveling to or from these events/activities).
This is a full and final release of any and all claims for injuries, damages and other losses of participant, expressly including claims for negligence of WPC agents, representatives, and employees.

The signature(s) below affirms our understanding of, and agreement to abide by, the statements herein. I/We agree with all statements, terms and conditions of the consent for emergency medical treatment and release of liability and consent to participate.

_____________________________________________________ Parent/Guardian Signature Date Signed____/____/_____

Tuition: $400/participant

Payment *

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