Camp Kids Groove| MEOW Academy|104 Mendel Parkway, Montgomery, Al|

MEOW Academy offers this summer enrichment camp to offer a 2 week adventure in music lessons. Guitar, drums, voice, and piano. The price is only $325.00 with breakfast and lunch being served daily.

Camp Kids Groove takes place the 2nd and 3rd weeks of July 10th-22nd.

email:meowforschools@gmail.com

Camp Kids Groove Registration

Get signed up now!!!

Student First Name*

Student Last Name*

Student Age*

Address

City*

State*

Email*

Parent First Name*

Parent Last Name*

Cell Phone*

Home Phone*

Emergency Contact*

Cell Phone*

Relation to Student*

Medical Conditions or Allergies If yes, please explain.

Dietary Requirments? If yes, please explain.

Insurance Policy Number

Policy Provider

Primary Physician

Authorized Pick Up Person 1*

Authorized Pick Up Person 2

Authorized Pick Up Person 3

Photo Release

I hereby give permission for my child to be photographed during Camp Kids Groove. I understand the photos will be used to keep a

journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers,

brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her

identity will not be disclosed, I do not expect compensation and that all photos are the property of MEOW Academy and its affiliates.

MEOW Academy and its co-organizers are not responsible for lost or damaged personal property. All scheduled events are subject to

change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per

physician orders. Children's’ photos and quotes may be used for publicity purposes. In case of an emergency, and if a family physician

cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. EMT, First Responder, and/or

Physician).

Parent Signature

Thanks for registering.