Summer Show Choir &
Jazz Camp
CHECK CAMP CHOICE: Resident Camper: Registration, Campus Housing, Meals (includes Breakfast, Lunch, Dinner), Music, Camp Shirt
Day Camp Only: Music and Camp Shirt
June 23—29, 2019 Deadline to register is June 15, 2019
Fill out this form completely
Camper Name: _______________________________________________________
Address: ____________________________________________________________
City / State: __________________________________________________________
Phone: (______) ____________________ Cell: (______) ______________________
Email: _______________________________________________________________
T-Shirt Size (circle one): Adult— SM M L XL XXL
Name of School: _______________________________________________________
School Phone: (______) ____________________Age: ___ Birthdate: ___/___/___
Parent /Guardian Name: ________________________________________________
Emergency Contact: ____________________________________________________
Phone: (_______)______________________
Resident Camper—Preferred Roommate (two campers per room):
_____________________________________________________________________
All registrations must be accompanied by full payment.
Return: COS Enrollment, Camp Registration, Medical Authorization, and Voluntary Activities Participation Forms with Payment to:
COS Foundation, 800 College Avenue, Weed, CA 96094
Questions about the Show Choir Camp?
Contact Ron Slabbinck, Camp Director
Email: [email protected] www.siskiyous.edu/camps/
Payment Options: VISA/MASTERCARD Personal Check or Money Order (Payable to College of the Siskiyous)
Card Number: __________________________________________________________________ Exp Date: ______________
Name on Card: __________________________________________ CVV #: _________ Billing Zip Code: ________________
Amount to be Charged:.
California Residents: ____ $297.00 Resident Camper ____ $42.00 Day Camper Only
Out of State Residents: ____$382.00 Resident Camper ____$42.00 Day Camper Only
