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Harry's Summer Music Camp Registration
Camp Dates: June 25-27 9 am to 12 pm OR July 23-25 9 am-12 pm
Address: Surf Ballroom Music Enrichment Center 509 Buddy Holly Place, Clear Lake Iowa
Contact: karenmiller@houseofnote.org or 641231-4927
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Which Camp would you like to register for?
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June 25 - 27 from 9 am to 12 pm
July 23 - 25 from 9 am to 12 pm
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Student Name
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Your answer
Email Address:
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Your answer
Home address:
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Your answer
Parents Name:
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Your answer
Phone:
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Your answer
Emergency Contact:
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Phone:
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Your answer
Relationship to Student:
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Age of Student:
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Grade Entering in Fall 2024:
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Your answer
Allergies or other medical conditions we need to be aware of:
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Your answer
Level of piano study:
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Choose
New Beginner
1 year lessons
2-3 years lessons
4 or more years of lessons
I agree to allow my child to be photographed. These pictures may be used by the Surf Ballroom Music Enrichment Center or House of Note Music Studio for promotional purposes. Names will not be shared.
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Please ask on a case by case basis.
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I understand that my registration is not complete until payment has been received. Space is limited and we are not able to hold spots.
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Scan this QR Code to book your spot in the June 25-27 Camp
Scan this QR Code to book your spot in the July 23-25 Camp.
We can't wait to see you at Harry's Music Camp! Keep an eye out for your official Owl Post Service!
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