2022 Summer Programs Form

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(610) 489-3676info@cmsmusic.org

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Community Music School

Community Organization Providing Quality Music Programs

Home
About Us
Programs
Concerts/Events
Partner With Us
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Contact Us

Home
About Us
Programs
Concerts/Events
Partner With Us
Registration
Contact Us

Student Name*
Date of Birth*
MM slash DD slash YYYY
Grade in September?*
School / District*
CMS Summer Camp Programs
Please select the camp your child is enrolled in. Please check all that apply.
Summer Camps
- Musikgarten Nature Trail Camp - June 26-30, 2023
- Musikgarten Camping at the Seashore Camp - July 10-14, 2023
- Progressions Jazz Camp - July 10-14, 2023
- Cello Camp - July 17-21, 2023
- Bravo Musical Theatre Camp - July 24-28, 2023
- Vivace Violin & Viola Camp - July 31-August 4, 2023
- Piano Camp - July 31-August 4, 2023
How Did You Hear About CMS Summer Camps?
- Referred by a friend/family/teacher
- Drive-By
- Web Search
- Social Media
What Instrument(s) or Voice Part Does The Enrolling Student Play/Sing?
How Many Years Has The Enrolling Student Played Their Instrument(s)?`
Private Lesson Teacher's Name
Private Lesson Teacher's Phone and/or email address:
Are there any special needs or requirements for your child that you would like the instructor(s) to be aware of?*
- Yes
- No
If yes, please describe
Family Information
Parent or Guardian if student is under 18
Mother/Guardian*
Father/Guardian*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Home Phone
Cell Phone
Preferred method of contact
- Email
- Home Phone
- Cell Phone
Student Medical Information In Case of an Emergency During Camp Hours
Does The Student Have Any Special Needs or Medical Issues? If Yes, Please Explain:*
Is The Student Currently Under Medical Treatment? If Yes, Please Explain:*
Emergency Contact Name If Parent/Guardian Cannot Be Reached:*
Relationship of Emergency Contact:*
Emergency Contact Phone #:*
Name of Health Insurance Company*
Insurance Group #*
Name of Primary Physician*
Phone Number of Primary Physician*
Authorized Person for Pick-Up Other Than Parent/Guardians:*
Phone # for Authorized Person For Pick-Up
Parent/Guardian Online Signature*

Your signature indicates that you agree to abide by all CMS policies and procedures as outlined in our student handbook and on the CMS website. Your registration cannot be processed without a signature or payment.
Date*
MM slash DD slash YYYY
Name
First Last

Δ

Community Music School

775 West Main Street
Trappe, PA 19426

Phone: (610) 489-3676
Email: info@cmsmusic.org

Community Music School is a non-profit community organization providing quality music programs for students and audiences of all ages. With a professional teaching faculty, a 200 seat performance hall, and 18 teaching studios, we offer music lessons, classes, and ensembles for all instruments and all ages

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CMS Hours

Monday: 10a – 9p
Tuesday: 10a – 9p
Wedneday: 10a – 9p
Thursday: 10a – 9p
Friday: 3p – 7p
Saturday: 9a – 3p
Sunday: Closed

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2022 Summer Programs Form

CMS Summer Camp Programs

Family Information

Student Medical Information In Case of an Emergency During Camp Hours