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. Consent My child has permission to walk home on their own.By selecting this button you grant Caffe Lena permission to allow your child to leave the premises unattended by an approved adult. Additional PhoneIf 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)Does your student have an IEP at School? YesWe ask so that we can prepare the best musical education for your child. We may reach out to discuss best practices with you. In Case of Emergency Call 911 immediatelyBy click this box I grant Caffe Lena and it's employees to call 911 in case of emergency in addition to calling the numbers listed. 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!Consent(Required) I agree to the privacy policy.Caffe Lena will not share any of this information with anyone, unless they need to know for purposes of creating a safe educational environment for your child.
