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SUMMER MUSIC ACADEMY

REGISTRATION Please fill out both sides of this form, detach and return to your ETM teacher

or complete and mail to ETM, or register online at www.ETMSMA.eventbrite.com. Registration deadline is Wednesday, June 4, 2014.

Parent/Guardian Name Address City, State, ZIP Home Phone Cell Phone E-Mail Address

EDUCATION THROUGH MUSIC

SUMMER MUSIC ACADEMY JULY 7 -31, 2014 MONDAY-THURSDAY

Emergency Contact Name Relationship Emergency Phone

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MEDICAL INFORMATION

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Allergies (write “none” if no allergies) Medications Currently Taken (ETM cannot administer medication)

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Medical Conditions (include ADHD and any other behavioral conditions within the last 3 years. Please write “none” if no medical conditions exist.)

Doctor Name and Number I give my permission for to take part in the ETM Summer Music Academy. I understand that this program takes place at MS 529, 3750 Baychester, Bronx, NY. I understand that my child will be participating in physical, musical activities in the school building under appropriate facilitation of ETM staff members. I agree not to hold Education Through Music, MS 529 or any of their agents responsible in the event of injury to my child. Parent/Guardian Signature

EDUCATION THROUGH MUSIC

122 East 42nd Street, New York, NY 10168 www.ETMonline.org 212-972-4788

Band

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KEEP THE MUSIC PLAYING ALL SUMMER LONG!


SUMMER MUSIC ACADEMY

SUMMER MUSIC ACADEMY What is ETM Summer Music Academy?

REGISTRATION

Please fill out both sides of this form, detach and return to your ETM teacher or complete and mail to ETM, or register online at www.ETMSMA.eventbrite.com. Registration deadline is Wednesday, June 4, 2014.

Student’s Name Age Date of Birth M/F (circle) School Grade completed as of June 2014

A wonderful opportunity for students to continue their musical learning over the summer.

PROGRAM SELECTION:

Morning session: 9 am – 12 pm

Full day: 9 am – 4 pm

Who can attend ETM Summer Music Academy?

(Choose one morning session)

(Choose both AM and PM session)

(Band and Orchestra students must bring their own instruments. * Guitars will be provided by ETM.)

qOrchestra (AM) qChoir & Musical Theater (PM) qBand (AM) qChoir & Musical Grab Bag (PM) qGuitar (AM)

How can I attend ETM Summer Music Academy?

Band and Orchestra students, what instrument do you play?

All ETM music students currently in grades 4 through 8. Orchestra and band students must have participated in their school’s ensemble program for at least one year.

Interested students should fill out the form on the next page (both sides) or register online at www.ETMSMA.eventbrite.com. You must choose a morning (AM) ensemble (Orchestra, Band, or Guitar). Full day students must also choose an afternoon (PM) session. Musical Theatre will include a Broadway-style performance; Musical Grab Bag will incorporate World drumming; steel drumming; ukelele playing; Orff instruments, etc.

Dates, Times, Location

MS 529. 3750 Baychester Ave., Bronx, NY July 7th through 31st, 2014 Mondays Thru Thursdays Morning (AM) Session: 9 am - 12:00 pm Full Day Session (AM & PM): 9am - 4 pm

Cost (for all four weeks)

Morning only: $200 Full Day: $300 (Full day students must pack a bag lunch) Checks or money orders should be made out to: Education Through Music SMA. Credit cards accepted: Visa, Master Card and AMEX. PAYMENT IN FULL DUE BY June 4, 2014 TO GUARANTEE PLACEMENT * Music Arts rentals and loan agreement can be extended to cover SMA. See ensemble teacher for details.

PAYMENT FORM (Check one)

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Morning Session: $200

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Full-Day: $300

Method of Payment (check one)

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Money Order q Check q Visa

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MC

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Card Number Exp. Date Card Holder Name Signature

EDUCATION THROUGH MUSIC

122 East 42nd Street, New York, NY 10168 www.ETMonline.org 212-972-4788

Amex


ETM Summer Music Academy 2014