HAMILTON SUMMER MUSICA PALOOZA- 1955 Upper James St.

Ages 7-13

July 2nd-12th

Child's Information
Child Name *
Child Name
Date of Birth *
Date of Birth
Exceptions made for campers turning 7 this year
Child's Health Information
Family Physician's Phone Number *
Family Physician's Phone Number
Parent or Guardian Information
Name *
Name
Address *
Address
Phone Number *
Phone Number
Emergency Contact
Name *
Name
Phone Number *
Phone Number
Other Information
ATTENTION: CHILDREN SIZES
Extended Care
(Maximum 1 hour prior and 1 hour after) 8am-9am/ 3pm-4pm (Pay Per Day Option Available On Arrival)
I give permission for my child to be in pictures and videos for Musica Palooza Camps *

Pay by Credit/Debit Visa/Paypal/ Cash (please notify via email)