EmailMe Form - St. George's Orff Ensemble Registration

St. George's Orff Ensemble Registration

When: Thursdays, 5:00-5:45, 1/5/17-5/18/17
Where: St. George's Parish Hall
Who: Any child between the ages of 6-12
How much: $40/month ($50 in five-week months; discounted rate available for St. George's members)

***To secure your child's spot in the class, payment is due promptly at the beginning of each month.***

To complete your registration, please mail payment to the following address (and clearly indicate that it is for the Orff class):
St. George's Episcopal Church
5520 Far Hills Ave.
Dayton, OH 45429

Please contact Christin Rondeau at orff@stgeorgeohio.org with any questions!

Parent's Name
First Last
Student's Name
First Last
My child is a returning member of St. George's Orff Ensemble, and our information has not changed. (If "yes," you may skip to the bottom and click "submit.")
Yes
No
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email
Student's Age
Primary Phone
### - ### - ####
Secondary Phone
### - ### - ####
Family's Church, if applicable
Names of individuals who may pick your child up from class
Student's School
Student's Musical Background
The St. George's Orff Ensemble offers need-based scholarships to eligible families. Would you like us to contact you with more information about this program?
Yes
No
May we use your child's image for marketing purposes (for example, a group photo on the class Facebook page)?
Yes
No

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