North Muskegon Elementary Strings Class Registration
2011-2012
(Please print, fill out, and return to Mrs. Corbin before Wednesday, September 14)
Student Name:_________________________ Grade: ____ Teacher: ________________
Instrument Choice: _______________________ Birthday:_____________
Food Allergies or any other unique needs that Mrs. Corbin should be aware of: ________________________________________________________________________
Please list any other instruments played:_______________________________________
Parent Name:__________________________________Parent phone:_______________
Email address(es):_________________________________________________________
Parent Name:__________________________________Parent phone:_______________
Email address(es):_________________________________________________________
Please circle the best description(s) of the student’s level of experience (circle one or more):
o Total Beginner (never played)
o Beginner (learned violin only in 2nd grade)
- Played in 2nd and 3rd grade
- Played in 2nd, 3rd, and 4th grade
- ___years of private instruction
- other:_____________________________________________________________
My student is interested in private lessons. Yes / No
My student already has an appropriately sized instrument. Yes / No
I plan to attend the rental night on September 15th at 6:30 PM. Yes / No
I am interested in helping/joining the Music Boosters. Yes / No
I may be available to help with concerts. Yes / No
____pre-concert backstage help (lining up, supervision, etc.)
____concert recording (taking video of concerts and getting a copy or
copies on DVD to Mrs. Corbin)
____bringing snacks/drinks
____post-concert stage clearing
____other: _________________________________________________
Student/Parent Pledge
I understand that learning an instrument requires focused participation during class times as well as consistent and careful home practice. I will do my best to be prepared for class each week and all performances. I will learn my music on time and bring my instrument and music to each class. When I am frustrated, bored, or struggling, I promise to contact Mrs. Corbin and ask for advice or help. I will take care of my instrument responsibly.
Student Signature: ___________________________ Date: __________
Parent/ Guardian Signature: _________________________ Date: __________