Rock’n Music

SUMMER CAMPS 2010

Online enrollment form

Instrument(s): Guitar       Bass       Drums        Keys/Piano        Vocals

Week(s):         July 12-16      July 26-30       Aug. 9-13       Aug. 23-27 (recording camp)

Student Information (please print):

Student Name: ____________________________________________

Address: ________________________________________________

City: ___________________________    Zip:____________________

Phone: Home  _____________________________________________

             Cell _______________________________________________

Contact:   _________________________________________________

Age: __________  Experience: ________________________________

Email: ____________________________________________________

Allergies: _________________________________________________

Favorite bands and/or songs?__________________________________

How did you find out about the camp?:  ___________________________

A $100 deposit is required to reserve a slot.

Payment can be made by cash or check made payable to Rock’n Music Academy.

Print out and mail completed entry form along with $100 deposit to:

• Rock’n Music Academy- 500 Highway 35 South - Red Bank, NJ - 07701

You will receive confirmation via e-mail.