Jen Lapinski Music & Lil' Rockers After School Guitar Program

Forms

Lil' Rockers Summer Camp Registration Form

Please fill out the following form to register your child for the Lil' Rockers Rock Band Camp. One form is required per Rocker.

Camps are $280 (9am-3pm M-Fri with Concert held Friday from 4:30-5:00pm)

Camp #1 fees must be paid in full by May 31st, 2013. If your camper is unable to attend, you can receive a refund, minus a 9% administrative fee, through June 10, 2013. After June 10th, the fee is non-refundable.

Camp #2 fees must be paid in full by June 30, 2013. If your camper is unable to attend, you can receive a refund, minus a 9% administrative fee, through July 8th, 2013. After July 8th, the fee is non-refundable. **After Care available**

Lil' Rockers Name(required)

Lil' Rockers Age(required)

Select the Camp Your Lil' Rocker Would Like to Attend:(required)

Rocker would like to play.... (required)

More than one can be selected by holding down Ctrl + "instrument" :)

Does your child have experience playing an instrument? (required)

If so, what? :)

Does your child have any allergies/special needs?(required)

If so, please explain :)

Parent Contact Info (Phone/Email)(required)

Anything else..?

Does your child require aftercare? ($15/week/child pre-reg). If so, please list the desired days and times aftercare is required.(required)

After Care Available up to 4:30pm each day

Is it ok for us to photograph your child? (Marketing Purposes)(required)

Would you like to be added to the Lil' Rockers Mailing List?(required)

Enter letters shown in box below: (required)

Jun 8 5-8pm	Denver, CO Garden Tour After Party 23rd Ave Sculpture Studio (Sponsored by Conflict Center)
Jun 17 9am-5pm M-F	Denver, CO Lil' Rockers ROCK BAND Summer Camp @ Highlands United Methodist Church
Jul 15 M-F 9am-3pm	Denver, CO Lil' Rockers ROCK BAND Summer Camp #2 @ Highlands United Methodist Church