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Enrollment Form

To enroll, fill out the form below, or download a printed PDF application to return to 14 E. Maple St., Three, Oaks.

Enrollment Application PDF

Student's Name

First Name

Last Name

Instrument

Number of Classes

30 or 45-55 minutes

Start Date

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Alternative Phone

(###)

###

####

Check if student is affiliated with:

Berrien Springs Parent Partnership

Niles Public School

Home Schooled

Public, Private, or Parochial School

Adult

Photo/Video Release:

By signing this form, I authorize the School of American Music to use or publish any photographs/videos taken of me or my child/children to promote classes on the website and other publicity now and in the future. Release And Waiver Of Liability and Indemnity Agreement: By signing this form, I release the School of American Music and its officers, agents and employees from all liability to the undersigned (and from any minor participants for whom the undersigned has the capacity to contract), thereby releasing indemnifying, and holding harmless the School of American Music, its officers, agents, and employees from all liability to the undersigned (and to said minors) for any loss or damage on account of physical, mental and emotional injury to the undersigned (of said minors) caused by the School of American Music, its officers, agents and employees. I am releasing as it applies to myself and to any minor for whom I am signing. (Type in name.)

Absentee Agreement

Absence/No Show/Cancellation: Please sign below to agree to give notice of absenteeism directly to the teacher by phone or email at least 24 hours in advance.

Parent or Guardian Signature

Signature of Parent or guardian if participant is under 18 years of age.

Date

Payment Options

• Pay Online • Checks made out to the School of American Music at first lesson. SCHOLARSHIPS are awarded for 10-week sessions on a percentage basis. One scholarship is available for each student for each 10-week session. Scholarships are generally offered at a 25- or 50-percent. discount. The Scholarship Fund is supported by donations and by fees paid for performances by student/faculty musicians.