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MAPLE AVENUE MUSIC

& Preschool Programs

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Preschool PALS
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Summer Voice Program

Parent First Name

Parent Last Name

Email

Student's Name

Student's Birthdate

I understand that student absences cannot be filled, so they are not refunded.

Does the student have any ongoing medical condition that could cause an issue at lessons (i.e. asthma, diabetes, allergies, etc)? If not, please type NO; if yes, please specify:

Should a medical emergency arise concerning my child at lessons, I release Mrs. Wenger from liability and assume cost of related treatment expenses.

Which lesson format does the student prefer?

If DUO format... name of friend joining the student:

Which songbook will the student purchase prior to the first lesson?

I understand Mrs. Wenger will contact me to finalize scheduling and confirm payment (due June 3) at the email address given above.

“My child loves Sharon’s puppets and is always excited to show me all the different ways he has been taught to write his name.”

- Danna, Pre-k PALS Parent

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