Child's Name:

Guardian's Name:

Dates:

What dates will your child attend? Check all that apply.

July 14th - July 18th

July 28th - Aug 1st

What grade is your child?

List the name of any family members and caregivers who will be picking up your child:

Email

Emergency Contact 1:

(###)

###

####

Emergency Contact 2:

(###)

###

####

My child has allergies:

Yes

No

List allergies:

Anything else you think we should know?

I understand that there will be no reimbursements or make-up classes. I agree to Music Art Puppet Sound INC's terms, which can be viewed on our "Terms" page.

Yes

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