Songbird Summer Camp 2024 Registration Form

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Welcome to Songbird Music Summer Camp 2024!

Please fill out this form to register for camp. You will receive a confirmation email within 24 hours. Your spot will be reserved once you submit the $100 deposit.

Email *

Name(s), age(s) and pronouns of Camper(s) : *

Does the camper have any experience singing, playing an instrument, or making music? If so, please explain below.

If not, please share some musical instruments and activities your camper would be interested in exploring during camp.

Caregiver(s) Name and Pronouns *

Caregiver(s) email address

Caregiver(s) phone number

Emergency contact 1:

(Full Name, relationship to child and phone number)

Emergency Contact 2:

Full Name, relationship to child and phone number)

Please share some of your child's strengths in group settings

Please share how I can support your child while they are at camp including any accommodations they may need.

Does your child have any allergies or other medical needs that I need to know about? If so please explain below.

Does your child take any medication that they will need to take during camp? If so please explain in detail below. *

Will your family need before-care or after-care during the week of camp (at an additional cost)? *

Yes, I need before-care only.

Yes, I need after-care only.

Yes, I need both before- and after-care.

No.

I'm not sure yet.

Camp tuition per child for this week of camp is $300. A deposit of $100 is required to hold your spot. The remaining balance will be due June 1st. If you would like to work out a sliding scale rate with me, please mention that on the line below. Otherwise, please enter the total deposit amount you will pay on the line below. (1 camper = $100, 2 campers = $200 etc) *

Additional comments/questions:

Please send the deposit amount listed above to reserve your camp spot. If camp is cancelled at any point due to low enrollment or another reason on my end, you will receive a full refund of your deposit and/or tuition. If you need to cancel your camp spot, please cancel as early as possible so I can try to fill the spot. If you cancel within 30 days of the first day of camp, I will do my best provide a full or partial refund of deposit/tuition, but I can't guarantee a full refund.

Payment Options:

Paypal: rainbow2616@hotmail.com

Venmo: @Bethany-Cann

CashApp: $SongbirdMusicPhilly

Zelle: rainbow2616@hotmail.com

Check your payment method or situation below:

Venmo Payment

Paypal Payment

CashApp Payment

Zelle Payment

In person (cash, check etc), will make arrangements via email.

Will pay later, I know my spot is not reserved until I make the payment.

I am requesting a sliding scale payment plan.

Other:

A copy of your responses will be emailed to the address you provided.

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