Summer Music (Virtual) Camp Registration Form

Student Information
Name*
First Name Last Name
Phone*
Email*
Allergies*
Photo/Video Release
I grant Zion Lutheran Church the right to photograph and/or video myself and/or my child(ren) in connection with Zion's events. I authorize Zion Lutheran Church, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I have read and understand the above:
Signature*
Name*
First Last
Relationship*
*
- I DO NOT authorize Zion Lutheran Church to photograph and/or video my child(ren).
- I DO NOt authorize Zion Lutheran Church to photo/video myself
Comments:
Please comment the skill level or if your child has any previous music experience, so we can group children accordingly
Comments
This field is for validation purposes and should be left unchanged.

Student Information

First Name	Last Name