Summer Music Camp
Grades 4-6 Student Registration
Student Name
*
Grade as of Fall 2019
*
(Choose One)
4
5
6
Lunch
*
(Choose One)
Yes, I would like the City of Hoboken to Provide my child lunch.
No, I will provide my child lunch daily
Parent Name
*
Parent Phone Number
*
Parent Email
*
Emergency Contact Name
*
Emergency Contact's Phone Number
*
Approved Pick Up List
*
I give permission for my child to self dismiss
*
(Choose One)
Yes
No
I give permission for my child to be photographed/ videotaped by a representative of the Hoboken Public School District.
*
(Choose One)
Yes
No
My child is already enrolled in Theatre Camp
*
(Choose One)
Yes
No
Registration Options
*
I qualify for free lunch ($0.00)
I qualify for reduced lunch ($30.00)
Flat rate of $30 for all weeks
I do not qualify for free or reduced lunch ($100.00)
Flat rate of $100 for all weeks
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