Music JAM
Please fill out one form for EACH child who will be participating in our Music JAM.
For questions, please reach out to Mrs. Deb Smith (dsmith@stmattlutheran.org), 717-637-7101, ext 236.
For the most recent information, go to this link: https://stmattlutheran.org/music-jam-nov/
Child's Information
Child's Name
*
Child's Age
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Please list allergies and dietary concerns.
We want every child to feel safe, included, and supported. Please let us know if there is anything we should be aware of to help make this a positive experience for your child (medical needs, learning or behavioral supports, etc.).
We love sharing the fun and joy of our programs! We may take photos during events to share on our church’s website, social media, or printed materials.
Please select all that apply.
Check this box if you do NOT give permission for your child's photo to be used.
Parent/Guardian Information
Parent/Guardian Name
*
Email
*
This address will receive a confirmation email
Cell Phone
*
Submit
Description
Please fill out one form for EACH child who will be participating in our Music JAM.
For questions, please reach out to Mrs. Deb Smith (dsmith@stmattlutheran.org), 717-637-7101, ext 236.
For the most recent information, go to this link: https://stmattlutheran.org/music-jam-nov/
×
Please Fix the Following