OHLC-MusicFirst-Registration-Form

MusicFirst Classes at the

Open House Learning Center

Mondays

Mommy/Toddler 12:15-1:00pm

OHLC 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*

Class Choice -$65.00/6 wk Session *

Has your child taken Music Classes before?*

If your child has taken Music classes, please select which ones. *

Session Fee Total (each session is $65)*

Do you authorize OPMI to use photos of your child on our website and/or promotional material?*

	YES
	NO

OPMI Music First {arent/Payment Responsibility*

BY CHECKING THIS BOX, I understand that Parents are required to participate in ALL Infant and Toddler Classes. I also understand that each class is 45 minutes in length and that semester tuition fees are due at the beginning of the semester 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 6-week semester 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 has 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 includes any claims based on negligence

Special Comments / Concerns:

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OHLC MusicFirst Registration Form

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