Tri-Valley Summer Music Camp
STUDENT REGISTRATION FORM
| Student Information | |
| Last Name:
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First Name:
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| Address:
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| City / State / Zip:
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| Home Telephone:
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Birth Date:
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| Email Address:
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| Instrument(s):
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| Check Appropriate Camp(s) and Age Group: | |
| ___ Band Camp ($180*)
___ Jazz Camp ($95*) ___ Band & Jazz Camps ($260*) |
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| Grade of Student in the Fall: | ___ 6 ___ 7 ___ 8 |
| ___ Orchestra Camp ($180) | |
| Grade of Student in the Fall: | ___ 7 ___ 8 |
| * $10.00 discount per camp, or $240 for both Band & Jazz camps if registered before July 1, 2009 |
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| T-Shirt Size (Please Check One): | |
| ___ Adult Small ___ Adult Medium ___ Adult Large | |
| Please return registration, medical form, and appropriate fees, made out to Perazzo Studios, to: 2009 Tri-Valley Summer Music Camp Letters of confirmation and directions will be sent upon receipt of application. For inquiries, call Paul Perazzo at (925) 997-6241 |
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