Summer Music Camp Registration Form

Thank you for your interest in Summer Music Camp to be held Saturday, July 30, 9:30 - 3:30 p.m. at Fourth Presbyterian Church. The camp is free and includes lunch. Students who complete the camp will be invited to participate in special music at the 11:00 a.m. worship service the following day. Questions? Contact the music office at 301-320-3600 ext. 209 or Erin Jones at ejones@4thpres.org.
*1. Select one:
*2. School name for Fall 2022:
*3. School grade for Fall 2022:
*4. Please list any allergies or life-threatening dietary restrictions. Please also list any details associated with your child's symptoms of an allergic reaction. (How will we know?) If no allergies, please enter "none": 
*5. Does your student require an EpiPen?


*6. Does your student have any other medical conditions or special considerations you would like us to be aware of? If yes, please note them below. 
7.What instrumental, choral, or other musical experience does your student have?
8. Has this student had any private lessons? If yes, please note length of time.
*9. Parent(s) Name(s):
*10. Parent email address (if different from above):
*11. My home email system is a reliable means of receiving Camp-related information
*12. Parent cell phone number:
13. Parent address (if different from above):
*14. Emergency contact name:
*15. Emergency contact phone number:
*16. I give permission for photos/videos of my child to be taken during the music camp and/or  worship services to be used in future Fourth publications and on the website.  NO identifying information shall be included. 
Submit Form