MUSIC MAKERS APPLICATION FORM
PLEASE CHECK: Waterdown __ Oakville__ Grimsby/Stoney Creek__
Hamilton/Westdale__
YOUR CHILD'S NAME_______________________________________________________________________
DATE OF BIRTH (as of Dec.31st this year)______________________________________________________
PARENTS NAME(S)_________________________________________________________________________
PARENT'S SURNAME (if different from above)__________________________________________________
MAILING ADDRESS_________________________________________________________________________
__________________________________________________________________________________________
TELEPHONE #'s____________________________________________________________________________ OTHER CONTACTS_________________________________________________________________________ MEDICAL EMERGENCY #_____________________________________________________________
PLEASE INDICATE WHETHER YOUR CHILD IS A NEW STUDENT___ COMPLETED FALL PROGRAM__ COMPLETED SUMMER PROGRAM__
IF YOUR CHILD IS 5 YEARS OR OLDER, DO THEY HAVE THEIR OWN RECORDER?_________
PLEASE GIVE THE NAMES AND AGES OF OTHER CHILDREN IN YOUR FAMILY THAT ARE ENROLLED IN MUSIC MAKERS BELOW
_________________________________________________________________________________________
PLEASE LIST ANY ALLERGIES OR MEDICAL CONDITIONS ON THE BACK OF THIS FORM
I understand and agree to the terms set out by Music Makers
________________________________________
Signature
Email to:[email protected]
289 698-4789
PLEASE CHECK: Waterdown __ Oakville__ Grimsby/Stoney Creek__
Hamilton/Westdale__
YOUR CHILD'S NAME_______________________________________________________________________
DATE OF BIRTH (as of Dec.31st this year)______________________________________________________
PARENTS NAME(S)_________________________________________________________________________
PARENT'S SURNAME (if different from above)__________________________________________________
MAILING ADDRESS_________________________________________________________________________
__________________________________________________________________________________________
TELEPHONE #'s____________________________________________________________________________ OTHER CONTACTS_________________________________________________________________________ MEDICAL EMERGENCY #_____________________________________________________________
PLEASE INDICATE WHETHER YOUR CHILD IS A NEW STUDENT___ COMPLETED FALL PROGRAM__ COMPLETED SUMMER PROGRAM__
IF YOUR CHILD IS 5 YEARS OR OLDER, DO THEY HAVE THEIR OWN RECORDER?_________
PLEASE GIVE THE NAMES AND AGES OF OTHER CHILDREN IN YOUR FAMILY THAT ARE ENROLLED IN MUSIC MAKERS BELOW
_________________________________________________________________________________________
PLEASE LIST ANY ALLERGIES OR MEDICAL CONDITIONS ON THE BACK OF THIS FORM
I understand and agree to the terms set out by Music Makers
________________________________________
Signature
Email to:[email protected]
289 698-4789