Byfield, MA - (978) 462-9020

Summer Jam '06 

 Registration Form

The cost of Summer Jam is $475. A non-refundable registration fee of $150 reserves your place in a session. (Sorry, deposits are not refundable.) The balance of $325 is due 14 days before the first day of the Summer Jam session. Cash, personal check, Visa and MasterCard are accepted.

 

Summer Jam '06 Dates

Please indicate your first and second date choices below.  All classes are held from 9 a.m. to 1 p.m.

 

 June 26 - June 30

 July 10 - 14

 July 17 - 21  

 July 31-Aug 4 TBD (Please Inquire)

 

General Information

First Name
Last Name
Email Address
Street Address
City    State    Zip Code
Phone    Cell  
Age

  Instrument    Level of Play                                                                                                                                           (ie: intermediate etc..)

Parent

 

  Phone 

Required for participation under the age of 18                       If different from above
Emergency Contact (1)    Phone 

Emergency Contact (2)

  Phone 

   
Comments

 

 

Please do not include credit card information with your electronic submission. Call (978) 462-9020 with this information to avoid any internet security problems or print out this registration form and mail it to:

Summer Jam 2006
Pine Island Music Resource
P.O. Box 189
Byfield, MA 01922

Checks should also be mailed to this address. When sending a check, please indicate that an electronic registration was submitted and include the name of the registrant.

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Page last updated 3/21/2006 by mes.