| One form per student. Call the office for more information or to arrange payment for classes. |
| Student's Name: |
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| Age: |
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| Birthdate (XX/XX/XXXX): |
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| Sex: |
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| School: |
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| Current Grade: |
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| Parent's Name: |
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| Address: |
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| City: |
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| State: |
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| Zip Code: |
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| Home Phone: |
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| Work Phone: |
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| Cell Phone: |
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| Email (CFTAW use only): |
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| PRIVATE LESSONS
We will have an instructor contact you to arrange lesson times.
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| Instrument/Vocal: |
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| Musical Experience: |
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| Method: |
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| Session Length: |
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| Session Quarter: |
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| Preferred Day/Time: |
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| Orchestras: Audition Required. Please contact the office for more information |
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MIDWEST MOD. MUSIC SCHOOL, ART WORKSHOP, MUSIK KIDS,
SUMMER CAMPS DANCE & THEATRE CLASSES |
| Class 1: |
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| Class 1 Day/Time: |
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| Class 1 Fee: |
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| Class 2: |
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| Class 2 Day/Time: |
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| Class 2 Fee: |
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| Class 3: |
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| Class 3 Day/Time: |
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| Class 3 Fee: |
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| Choose Session or Quarter: |
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| If this is a sibling registration, please enter the sibling's information below |
| Student's Name: |
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| Birthdate (XX/XX/XXXX): |
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| Class Choice: |
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| Class Day/Time: |
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| Class Session or Quarter: |
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| Total Class Fee(s): |
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| +Registration Fee: |
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| =Total Fees: |
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Please make checks payable to:
The Center For The Arts, Wyoming (CFTAW)
322 Wyoming Ave., Wyoming, OH 45215
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| How did you hear about us? |
| Print/Magazine |
Family Living
All About Kids
Cinti Woman
Camp Fair
Other Print
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| If Other |
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| Flyer/Brochure (what/where?) |
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| Newspaper (Which one?) |
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| Website (Which one?) |
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| Other (explain) |
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Waiver/Liability Form
The above enrolled student has my permission to participate in classes and/or lessons at The Center For The Arts, Wyoming (CFTAW). I understand that participation in this program is at my/his/her own risk and that CFTAW will not be liable for any injury sustained or be responsible for any medical expenses incurred as a result of my/my child's participation in this class. I understand and accept the policies fo CFTAW as stated on this ewebsite and accept responsibility for charges and fees incurred. I will allow the CFTAW to use photographs; artwork and recordings made at CFTAW or at CFTAW functions, involving the student hereby enrolled.(Typing your name below acts as your signature.) |
| Signature: |
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| Date: |
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| *
For added security, type in the red characters, with no spaces, in the box to the right of them: |
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