Name: UAF SMA Late Registration - Full Day
SKU: 667
Price: 625.00 USD
Availability: InStock

Name of Academy Participant*

First Last

Gender*

Age*

Grade*

Address of Student*

Street Address Address Line 2 City State ZIP Code

Email address of student

Child's Instrument*

If "voice" is the instrument, please also type vocal category if known, e.g. Soprano, Alto, Tenor, Bass

T-Shirt Size

Please note: There are both "Youth" and "Adult" sizes.

Email address of Parent*

Address of Parent

*Enter only if this address differs from student address above.

Street Address Address Line 2 City State ZIP Code

Parent Daytime Phone*

Parent Cell Phone*

Emergency Contact*

Please list another person we can contact in case of emergency if we are unable to contact you.

First Last

Emergency Contact Relationship to Student*

Emergency Contact Daytime Phone*

Emergency Contact Cell Phone*

Medical Exceptions

If your child self medicates, has any allergies we should be aware of, or any other medical condition, please let us know here.

Can your student's photograph be featured on the Summer Music Academy website?*

Can your student's photograph be featured in the Summer Music Academy brochure?*

Can your student's photograph be featured in public news media?*

Can your student be interviewed for Public news media?*

UAF SMA Late Registration – Full Day