Registration Form:
Please enroll:______________________________________
_________________________________________________(full name of participants)
Age of camper(s) at camp time___________________
Participant’s Birthdate(s)  __/__/__   __/__/__
Parent’s Name(s)________________________________
Address_________________________________________________________________
City_____________________Zip____________Phone Numbers: (H)_________________
(W)_________________________Cell/Emergency_________________________________
Email__________________________

Which Session(s)?
Berkeley Music and Art
June 18____
July 2 ____
July 16____
August 20______
Creative String Chamber Camp
July 30_____

Instrument(s) if camper plays one____________________________________
Instument(s) interested in trying if any________________________________
Previous playing experience_____________________________________________________
___________________________________________________________________________

Payment:         (10% discount for sibling)     (extended camp hours $10.00 per hour)
Total tuition due:                                                                                          $______________
Total enclosed (50% dep. required to hold space):                                     $______________
Balance due (on or before 1st day of session)                                           $______________

Make checks payable to Irene Sazer  P.O. Box 2753.  Berkeley, CA 94702
Deposit must accompany registration to hold a space.
Parent’s signature____________________________________________________

How did you hear about us?__________________________________________________

A camp information packet will be sent to you before the start of camp