LSSM Summer - Music & Art Camps!

First Name (Parent) *

Last Name *

Address *

Address 2

City *

State/Province *

Zip/Postal Code *

Phone *

Email Address *

First Name (Child/Children) *

Last Name ( Child/Children) *

Age of Child *

First name of additional child

Last name of additional child

Age of additional child

Emergency Phone Number *

List any Allergies/Illnesses/Medical conditions. (Write "none" if none) *

What is your child's t-shirt size? *

What is your child's t-shirt size? Additional child

Preferred way to contact *

Phone

Email

Text

Choose an option below for Week 1. *

Half day (9:00 am - 1:00 pm) - $269.00

Full day (9:00 am - 3:00 pm) - $319.00

Not attending week 1

Dates Interested in?

Little Picasso Art Camp - June 17-21, (ages 4-6)

Exploration of Art Camp - June 17-21, (ages 7-12)

Exploration of Music - June 17-21, (ages 4-6)

Beginning String Class - June 17-21 (Elementary & Middle School Students)

Vocal/Singing Camp - June 17-21, (ages 7-11)

Guitar Camp - June 17-21, (ages 8+)

Drum Camp - June 17-21, (ages 8+)

Choose an option below for Week 2. *

Half day (9:00 am - 1:00 pm) - $269.00

Full day (9:00 am - 3:00 pm) - $319.00

Not attending week 2

Dates Interested in?

Little Picasso Art Camp - June 24 -28, (ages 4-6)

Exploration of Art Camp - June 24-28, (ages 7-12)

Exploration of Music - June 24-28, (ages 4-6)

All-State Orchestra Prep Camp - June 24 - 28, Camp (Middle & High School students) (Violin, Viola, Cello and Double Bass)

Vocal Boot Camp - June 24 -28, (ages 12+)

Terms and Conditions *

You consent to receive communications from us electronically. We will communicate with you by e-mail or phone. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

**EARLY BIRD SPECIAL($10 OFF)** Payment Options: Please choose one of the options below for payment **Card on file is for LSSM Students ONLY** *

Option 1 - One Student: I authorize Lawrenceville-Suwanee School of Music to charge the card on file $269.00 (HALF day) per week to complete the registration.

Option 2- One Student: I authorize Lawrenceville-Suwanee School of Music to charge the card on file $319.00 (FULL day) per week to complete the registration.

Option 3- Two Siblings: I authorize Lawrenceville-Suwanee School of Music to charge the card on file $538.00 (HALF day) per week to complete the registration. Each additional sibling will be $10 off.

Option 4 - Two Siblings: I authorize Lawrenceville-Suwanee School of Music to charge the card on file $628.00 (FULL day) per week to complete the registration. Each additional sibling will be $10 off.

Option 5 - Alternate form of payment: I will be registering today using an alternate form of payment. *You must call our Finance department at 678-559-7117 between the hours of 10am and 3pm Mon-Fri to complete registration.

By signing below, I confirm that I have a current student at Lawrenceville Suwanee School of Music and I approve Lawrenceville Suwanee School of Music to charge my card/account according to the option selected above. I understand that A completed registration form and payment is required to finalize my registration and that the registration fee is non-refundable after June 1, 2024. No exceptions.

clear

ACTIVITY RELEASE OF LIABILITY: for V.C. Giles Music, DBA Lawrenceville-Suwanee School of Music By signing below I/we expressly agree to release V.C. Giles Music Studio, LLC, all staff and volunteers associated with V. C. Giles Music Studio LLC, from any liability that arises from accidents or injuries which may occur during the course of participating in any program or activity sponsored by V. C. Giles Music Studio, LLC. Additionally, by signing below I/we acknowledge and accept the no refund policy. No refunds will be given for camps after June 1, 2024. *

clear

MEDIA RELEASE I hereby give my consent to all photographs, audio recordings, and/or video recordings taken of me or my child by V.C. Giles Music Studio, LLC staff or designee. I understand that any such photographs, audio recordings, and/or video recordings become the property of V.C. Giles Music Studio, LLC and may be used by the studio or others with their consent, for advertisement, or promotional purposes determined by V.C. Giles Music Studio, LLC in broadcast and media formats now existing or created in the future. *If you would prefer LSSM does not photograph the student(s) mentioned above, please write "NO PICTURES" instead of signature. *

clear