Center Stage Specials!
Refer a friend and get $10 off when they register!
Register for 3 summer camps classes and get 10% off!
The Tri-States Premier Performing Arts School!
(217) 357-NOTE (6683)
Student's Name:
Address
Age
City
State
Zip Code
Summer Camp Registration
Daytime Phone
Cell Phone
Home Phone
Mother's Name
Emergency contact telephone numbers for Parent/Legal Guardian
Email Address
Father's Name
Daytime Phone
Cell Phone
*Please note that the registration fee must be paid to be completely registered.
Cell Phone
Camp Title #1
Camp Title #3
Camp Title #2
Camp Fee
Camp Fee
Camp Fee
Registration Fee $5
(not applicable to current students)
In case of emergency if I can not be reached, I authorize the staff at Center Stage Music to obtain whatever medical treatment deemed necessary and agree that I am financially responsible for all charges and fees incurred in the rendering of said emergency treatment.
Injuries: Parents/guardians and students waive the right to any legal action for any injury sustained on school property.
Photo & Video Release: Photographs and video-taping of the students may be used in brochures promotional materials of the school. Permission is also hereby granted for the school to copyright such photographs in its name.
Your information will be kept completely confidential and will not be shared with anyone under any circumstances.
