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Application

For Creative Expressions Summer Programs

Welcome to Creative Expressions Summer programs! Please fill out the form below. If you are enrolling multiple students in the same household, please list all of their information on one form.

*Please submit payment through Zelle at PianoExpressions24@gmail.com. You will receive a confirmation email after payment is received to secure your spot.

To ensure proper processing, please include the student’s name with your payment. Thank you!

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Choose one or more:

Primary Contact

Emergency Contact(Other than primary contact)

Medical Information
** Please provide the up-to-date immunization record prior to camp starting. **

Does the child take any medications?

Physician’s Information:

Other Information (Known allergies, dietary restrictions, special accommodations, etc.):

Medical Treatment Authorization:

Privacy Agreement:

Creative Expressions Summer Program PolicyDownload