Shema Youth Orchestra: Summer Music Camp

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Dates: August 24-27 2022
Location: NJ Christian Academy, 73 Holmes Mill Rd Cream Ridge, NJ 08514
Registration Deadline: July 30

Tuition: $700 (Sibling discount: $50)
Payment: Zelle to shemagospel@gmail.com
Check payable to Shema Youth Orchestra 4232 235St Douglaston NY 11363

For more information: shemagospel@gmail.com/ Dir. Alice Kim 917-621-5511

Name of the Student *

Date of Birth *

YYYY

Grade as of September 2022 *

Address *

Student Phone Number *

Student Email *

Instrument *

Number of years playing your instrument *

Parent/Guardian Name *

Parent/Guardian Phone Number *

Parent/Guardian Email *

Emergency Contact Name and Number *

Any allergies or medical conditions *

Medical Insurance name and policy number ( In case of emergency)

If none of the named contacts can be reached, what do you want us to do if your child is sick or injured?

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