Camp & Class Attendee Information

Caffe Lena School of Music Camp & Class Attendee Information

This form provides Caffe Lena all the important information we need to safely and effectively support your student during all classes and summer camps.

Student Name(Required)

First Last

student's age and school affiliation(Required)

Parent/Guardian Name(Required)

First Last

Emergency Phone(Required)

Secondary Phone(Required)

Other approved adults for pick-up

These folks may pick up my child after class.

Additional Phone

If you child has a phone, please enter it here so that we may ensure we have contact if they are allowed to leave without an adult.

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Email(Required)

Does the student have any allergies?(Required)

What instruments does your student currently play?(Required)

Anything else you would like us to know?

Use this space to let us know if your child has a birthday happening during camp, or anything else that would help us give them the best experience!

Camp & Class Attendee Information

Caffe Lena School of Music Camp & Class Attendee Information

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