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Rockin Mozart Summer Camp Registration

Thank you for choosing to register for our summer camps at our Rockin Mozart Port Allen location! Please fill out the information below, and we will get you confirmed and scheduled for our summer camp enrollment.

Full Name*

Phone*

Email*

Home Address/City/Zip Code*

Name of Parent or Guardian (Type N/A if 18 or older)*

Name(s) of people allowed to pick up your child*

Medical Conditions

For our records, please confirm your location.*

Plaquemine

Port Allen

Donaldsonville

Zachary

Which summer camp will you be attending? (Select all that apply)*

Musical Bash (June 3-7)

Performance Camp (June 24-28)

Camp Times: Rockin Mozart summer camp dates are specified and are held from 9AM to 3PM respectively.*

I Understand

Curriculum Policy: Rockin Mozart reserves the right to choose the curriculum that will be used in the educational process.*

I Agree

Materials Policy: Rockin Mozart will not be held responsible for any materials or instruments brought from home to one of our locations. In the event any item is lost, damaged, or stolen, Rockin Mozart will not be held responsible to replace said items.*

I Agree

Student Pick Up Policy: By agreeing to this policy, you are agreeing to pick up your child on time after summer camps are ended for each day. A fee of $15 will incur for every hour a child is left unattended by a parent after camps are completed.*

I Agree

Hold Harmless Agreement: Rockin Mozart is dedicated to the safety and wellbeing of its students. However, in the event of the injury of a student, Rockin Mozart is not liable to pay for any medical expenses that may incur. *

I Agree

Registration and Payment Policy: Each Rockin Mozart Summer camp is $225 plus a $25 registration fee. At the end of this form you will pay the registration fee up front. After which you will be prompted by the location of your choice's management team to pay the full amount at the time each camp is held.*

I Understand

I have read and initiated all statements above and agree to abide by the regulations of Rockin Mozart, outlined in this contract.*

I Understand