Parent/guardian information:

First name:

Last name:

E-mail address:

Phone number - best for contact during time of camp, if needed:

Camper information:

First name:

Last name:

Birthday:

Grade entering in fall 2026:

T-shirt size:

Additional information

Allergies:

Anything else about your child that we should know?

Music background

Remember that no music background or knowledge is required!

Has your child participated in any type of music lessons (outside of school)?

What type?

Authorized Pick-Up Information

Please list the first and last name of the person that will pick up your child after camp each day.

List any additional persons allowed to pick up your child:

Please list the first and last name of anyone that is NOT allowed to pick up your child:

Liability Waiver & Acknowledgement

I, the undersigned parent or legal guardian, give permission for my child to participate in activities associated with Bethesda Music Camp. I understand that participation in camp activities may involve certain risks, including minor injuries that can occur during recreational, musical, and group activities.

I give permission for my child to be photographed and/or recorded during activities related to Bethesda Music Camp. I understand that these images may be used by Bethesda Lutheran Church for promotional purposes, including social media, printed materials, and the organization’s website. I understand that no compensation will be provided for the use of these images or recordings. If I do not wish for my child to be photographed or recorded, I will notify camp staff in writing prior to the event.

In consideration of my child’s participation, I release and hold harmless Bethesda Lutheran Church, Music Camp staff, its employees, volunteers, and representatives from liability for injuries, damages, or losses that may occur as a result of participation in camp activities, except in cases of gross negligence or intentional misconduct.

I certify that my child is physically able to participate in camp activities and that I will provide any necessary medical, allergy, or emergency information prior to attendance.

In the event of a medical emergency, I authorize camp staff to obtain necessary medical treatment for my child if I cannot be reached immediately.

By signing below, I acknowledge that I have read and agree to the Liability Waiver & Acknowledgement above.

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I agree that my electronic signature is the legal equivalent of my handwritten signature.