Summer Show Choir &

Jazz Camp

CHECK CAMP CHOICE: Resident Camper: Registration, Campus Housing, Meals (includes Breakfast, Lunch, Dinner), Music, Camp Shirt

Day Camp Only: Music and Camp Shirt

June 23—29, 2019 Deadline to register is June 15, 2019

Fill out this form completely

Camper Name: _______________________________________________________

Address: ____________________________________________________________

City / State: __________________________________________________________

Phone: (______) ____________________ Cell: (______) ______________________

Email: _______________________________________________________________

T-Shirt Size (circle one): Adult— SM M L XL XXL

Name of School: _______________________________________________________

School Phone: (______) ____________________Age: ___ Birthdate: ___/___/___

Parent /Guardian Name: ________________________________________________

Emergency Contact: ____________________________________________________

Phone: (_______)______________________

Resident Camper—Preferred Roommate (two campers per room):

_____________________________________________________________________

All registrations must be accompanied by full payment.

Return: COS Enrollment, Camp Registration, Medical Authorization, and Voluntary Activities Participation Forms with Payment to:

COS Foundation, 800 College Avenue, Weed, CA 96094

Questions about the Show Choir Camp?

Contact Ron Slabbinck, Camp Director

Email: rslabbinck@siskiyous.edu www.siskiyous.edu/camps/

Payment Options: VISA/MASTERCARD Personal Check or Money Order (Payable to College of the Siskiyous)

Card Number: __________________________________________________________________ Exp Date: ______________

Name on Card: __________________________________________ CVV #: _________ Billing Zip Code: ________________

Amount to be Charged:.

California Residents: ____ $297.00 Resident Camper ____ $42.00 Day Camper Only

Out of State Residents: ____$382.00 Resident Camper ____$42.00 Day Camper Only