Application

Please fill in all the required fields marked with an *

First Name *

Last Name *

Age *

Gender
MaleFemale

Address *

City *

Province / State *

Country *

Postal / Zip Code *

Home Phone Number *

Other Phone Numbers (cel and/or work) *

Parents Names *

Email (parent or guardian only)*

Family physician*

Medicare # *

Please list any allergies, medical conditions or health concerns*

Musical History

Have you attended our camp before?  Yes No

Music Education / Comments

Can you read music?  Yes No

Instrument *

Secondary Instrument (indicate N/A if no 2nd instrument) *

Level *
BeginnerIntermediateAdvanced

Instructor *

Instructors Phone Number

May we contact your music instructor?
 Yes No

Upon receipt of your application we may contact you for an audition prior to attending this camp. Please press the submit button only once. If you have filled in all required information you should see an "application complete" page with further instructions.

Privacy Statement: We will never pass on your personal information to anyone other than ourselves for camp registration purposes. Any information you submit here is kept personal and confidential.

A 100$ non-refundable deposit must be received by June 1st. Payments can be made by check, money order or cash in person.

Checks or money orders must be made payable to Metro Moncton School of Music and the full balance must be paid one week before the start of the camp.

Checks or money orders must be sent to:
Metro Moncton School of Music
388 St-George Street
Moncton, NB E1C 1X4