Fort Pierce Jazz & Blues Society

REGISTRATION FORM FOR CAMP 2025 AT THE BOTTOM OF THE PAGE

2025 Camp Registration

Applicant Information

Basic - Intermediate - Advanced required

Last Name required

First Name required

Email Address required

Address required

City required

State required

Zip Code required

School Affiliation required

Instrument required

Parent Information (if applicable)

Parent's Name

Phone Number

Email Address

Payment Information June 2-6, 2025

Camp fee required

Billing First Name

Billing Last Name

Billing Address Line 1

Billing Address Line 2

Billing City

Billing State

Billing Zip

Card Type required Visa

Card Number

Exp Month

Exp Year

Card Verification #

Visa or MasterCard: the three-digit card verification number can be found on the back of the card.

American Express: the four-digit card verification number can be found on the front of the card.

Verification required

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Jazz Camp

2025 Camp Registration

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