SummerMusic&PrivateDanceLessonsareavailablebasedoneachteacher’sschedule!

CallGreenleafat913.397.7071toinquire.t.

Don’t let yourself forget what you learned this year in music lessons. Enroll for the summer and keep your skills sharp!

Greenleaf Music & Arts Academy Summer 2013 Registration Form (1formperstudent)

StudentInformation: Name______________________Phone_________________CellorWorkNumber___________________Age________DOB_______Parent/Guardian__________________________Address______________________________________________________________E‐mail_________________________________________Allergiesorotherconcerns_________________________________________HowdidyouhearaboutGreenleaf(ifnew)?__________________________________________________________________________

T‐shirt:Child:6‐810‐1214‐16Adult:SMLXLXXL(Additional$12/FreeforBYBCstudents)

MethodofPayment(circleone): Visa Mastercard DiscoverCheckCash Card#_______________________________Exp.Date:__________SecurityCode______Nameoncard_______________________

NameofCamp/Class Dates TuitionFee

T‐shirtY/N

Total___________________Care of Students: The studio is not responsible for providing before or after class care for students. Students are not to be left for excessive time periods before or after their class. Parents are responsible for their child’s safety entering and exiting the building before and after class time. Injuries: Parents, legal guardians of minors, students, and adult students waive the right to any legal action toward Greenleaf or any of its employees or volunteers for any injury sustained on studio property resulting from normal class activity or any other activity conducted by the students before, during, or after class time. Photo waiver: Greenleaf may use photos of students and classes in promotional material without additional compensation. Withdrawals , Refunds, and Transfers: I understand that no class refunds will be issued, but that if I decide not to participate in the class before June 1, a credit will be generated for future Greenleaf tuition. After June 1, there will be no credits or refunds. There will be a $15 additional charge for class changes or transfers. Greenleaf Music & Arts Academy reserves the right to terminate lessons or cancel classes without notice. In such a case a full refund for unused lessons will be given. I have read and understand the above polic ies and procedures and agree to abide by them. _______________________ ____________________________ ____________________________ Student Name (please print) Signature of parent or adult student Date

1530E.KansasCityRoadOlathe,KS66061913.397.7071

www.greenleafstudio.org

1530E.KansasCityRoadOlathe,KS66061913.397.7071

www.greenleafstudio.org

Music Camp Registration Pleaseattachtomainregistrationform.

Name_______________________________________Age_____________

PrimaryInstrument__________________________________________SecondaryInstrument(s)ifapplicable_______________________________________________________________________________________

Howmanyyearshaveyoutakenlessons?__________________

Pleaselistcurrentlessonbooks/theorybooksincludinglevel:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Iwouldlikemydailyprivatelessontobein(circleone):

PIANOGUITAR VOICE

Iwouldlikeamusicteachertohelpmedevelopinthisarea:________________________________________________________________________________________________________________________________________________

Acting Camp Registration (Odyssey & John Wesley Camps)

Pleaseattachtomainregistrationformwithacurrentheadshot.Name_____________________________________Age__________Height_________PreviousActingExperience(Playandcharacter,dramaclasses):Icommittomemorizingalllinesbeforecamptime,acquiringcostume,attendingallrequiredrehearsalsandperformances,andpromotingtheshowtofamily&friends.Signatureofparentoradultstudent(over18):__________________________________________________________________________