Please enroll:______________________________________(full name of participants) Participant’s Birthdate__/__/__Parent’s Names________________________________ Address__________________________________________________ City_____________________Zip____________Phone Numbers: (H)_________________ (W)_________________________Cell/Emergency_________________________________ Email__________________________
Instrument(s) if camper plays one____________________________________ Instument(s) interested in trying if any________________________________ Previous playing experience (including any improv/alternative style experience)__________________________________________________________________ ___________________________________________________________________________
Payment: (10% discount for sibling) (extended camp hours $8.00 per hour) Total tuition due: $______________ Total enclosed (50% dep. required to hold space): $______________ Balance due (on or before 1st day of session) $______________ __I would like more info on:___________________________________________________ Make checks payable to Irene Sazer P.O. Box 2753. Berkeley, CA 94702 Deposit must accompany registration to hold a space. Parent’s signature____________________________________________________ or if not a minor, Participant’s signature_______________________________
How did you hear about us?__________________________________________________
A camp information packet will be sent to you before the start of camp
