MusicFirst Classes
Fridays 10:30-11:15am
This Form cannot be submitted until the missing
fields (labelled below in red) have been filled in
Little Orange Academy MusicFirst Registration Form
Please note that all fields followed by an asterisk must be filled in.
Parent/Guardian First Name*
Parent/Guardian Last Name*
E-Mail Address*
Street Address*
City*
Home Phone*
Child's Full Name*
Age*
---Select---
2
3
4
Class Choice ($65.00/month)*
---Select---
Fridays @ 10:30-11:15am
Where will your child go after their MusicFirst Class?
---Select---
With Classroom Teacher
Parent Pick-Up
Session Fee Total ($65/month)*
Do you authorize OPMI to use photos of your child on our website and/or promotional material?*
YES
NO
OPMI Music First Payment Responsibility*
BY CHECKING THIS BOX, I understand that monthly tuition fees are due at the beginning of the month and are NON-REFUNDABLE. I am responsible for payment in full. I understand that class is once per week. I acknowledge that there will not be a pro-rated rate or refund for any portion of the month that my child and I do not attend.
OPMI Music First Liability Waiver*
BY CHECKING THIS BOX, I AGREE THAT I HAVE READ AND VOLUNTARILY SIGN THIS AGREEMENT ELECTRONICALLY and further agree that no oral representation, statements, or inducement apart from the following written agreement have been made: IN CONSIDERATION, of being permitted to utilize the facilities, services and programs of ORLANDO PREMIER MUSIC INSTRUCTION, hereinafter referred to as “OPMI”, for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any off-site program affiliated with OPMI, the undersigned, for himself or herself and any personal representatives, heirs, children and next of kin, hereby acknowledges, agrees and represents that he or she releases OPMI and its staff members from all liability for any injury, loss or damage connected in any way whatsoever to participation in OPMI activities whether on or off of the premises affiliated with OPMI. He or she understands that this release included any claims based on negligenc
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