Golden Gate Boys Choir and Bellringers
Summer Camp Registration Form
Mail registration form to:
480 Larchmont Street
Hayward, CA 94544
Email registration form to:
2022 SUMMER MUSIC CAMP REGISTRATION FORM
Please complete and return this form to the choir office BEFORE: June 20, 2022
Camper Information
Camper's Name
_______________________________________________________________________________________________
Last Name, First Name, Middle Name
Camper Year (1st, 2nd, etc.) ________________
Junior Counselor Year (if applicable) ________________
Address
________________________________________________________________________________________________ Number / Street
_____________________________________________________________________________ _____________________
City / Zip Code
School Grade Next Fall : ___________________________
Birth Date:_____________/______/__________
Parent / Guardian Information
Home Phone / Work Phone –
Father/Guardian (home)_____________________________________(work)______________________________ (mobile) ____________________________________
Mother/Guardian (home)____________________________ (work)_________________________ (mobile) _____________________________________
If you expect to be at a different address or phone during the camp session, indicate dates: ___________________________________________________________
Please give address and phone where you can be reached during the above period: Address:________________________________ City/Zip___________
Cell Phone ( ) _______________ E-mail address: _____________________________________
Camper's Travel Inquiry
Has your boy ever been away from home or family for more than one week? ________ If yes, for how long? ______________ When? ________________________________________________
Reason _________________________________________________________________
Please explain how the experience was pleasant or unpleasant _____________________________________________________________________________ _____________________________________________________________________________
Camper's Skills, Abilities, and Needs
Please indicate the camper's skills in:
Swimming: ____________________________________________________________________
Sports: _______________________________________________________________________
Camping & Backpacking _________________________________________________________
Indicate your boy's special interests: ________________________________________________
Hobbies: ______________________________________________________________________
Abilities: ______________________________________________________________________
Special Problems and Needs:
_____________________________________________________________________________
_____________________________________________________________________________
Permission to Attend Summer Camp
My son has permission to attend the Golden Gate Boys Choir and Bellringers Summer Music Camp and to participate in the camp program and activities. In an emergency, when I cannot be reached by telephone, the Camp Director and/or the Artistic Director may take whatever action may deem necessary for the safety of my son.
Signed:________________________________________________________________
Relationship___________________________________Date______________________
Signed:_________________________________________________________________ Relationship__________________________________ Date_______________________