Name

Sex:
Male
Female

Parents Name

Address
Home Phone Cell Phone

Instrument of Interest: (may check more than one)

Guitar
Keyboards
Bass
Drums
Vocals
Other

If yes, with who and for how long

Week Attending:

Aug 2-6 Aug 9-13 Aug 16-20

For Payment, please call with Mastercard, Visa, or American Express number at 760-753-6683
Any Questions call Tracy Pompeo at 760-473-8912