Asthma Blues Mini-Camp 2026 Registration

Parent/Camper Information

The Asthma Blues Mini-Camp is offered the second Saturday of the month from 10-11:30 AM Central Time on Zoom. It is conducted "live" by Mr. Al Keith, RRT, Respiratory Therapist, Musician, and creator of the Asthma Blues music program. Complete this information by the first Saturday to be eligible for the Mini-Camp at no cost (grant funded).

Question Title

* 1. Please enter name of parent/guardian, persons with asthma, and contact information.

Parent/Guardian Name & Relationship

Names of the Persons with Asthma & Ages

Parent/Guardian Email Address

Alternate Email

Parent/Guardian Cell Phone Number

Alternate Phone number

Zip/Postal Code

County

State

Do you have any questions about the camp?
Contact Ellen Buckner: email - ebbuckner@gmail.com
OR by phone: 205-910-9877

Thank you for your interest!