Resonance Piano Camp Registration Form
Thank you for your interest in Resonance: Mind-Body-Music, LLC! All camps and lessons are held at 112 N. Main Street, Pearl River, New York inside Good Shepherd Lutheran Church. All levels and backgrounds are welcome! Please fill out the following registration form. Thank you!
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Student's Name *
Parent/Guardian Name(s) *
Student's Birthdate (This camp is open to students age 4-6 years old) *
Best Cell Number *
Alternate Phone Number
Email to correspond with Elaina *
Email where invoice should be sent if different from above. $50 deposit due upon registration (you will receive an email invoice), remaining balance due first day of camp.
Student's interests *
How did you hear about Resonance: Mind-Body-Music? Referred by?
I am interested in the following Resonance Piano Camp, located at 112 N. Main Street, Pearl River, NY: *
Required
Name of Parent/Guardian authorized to pick up your child from camp: *
Any other comments/information that might help me as I prepare lessons for your child?
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