Summer Programs Application

Please fill out the application below to enroll students in the Bigel Music Summer programs. When you submit the application you will be asked for a non-refundable deposit of $50 to ensure the student's place in the program. The deposit will be processed through the secure Paypal site. You can pay with Paypal or by credit card.

In order to provide the best experience possible for your child, please answer the following questions accurately.

Student's Name:

Parent or Guardian's Name:

Email:

Phone Number (9999999999):

Please select program:

How old is the student?

Have they played any instrument before? Yes No

Please indicate the instruments that the student has expressed an interest in?

If there is any other information that would be helpful to us, please indicate here:

Please answer the following question for Rock Band students only:

What best classifies the student's playing ability?

Beginner

Intermediate

Advanced

Liability Waiver: I agree not to hold BIGEL MUSIC, Larry Bigel or any of his staff responsible for any accidents or injuries caused by normal class participation at the designated facility. There are no make-ups or credits issued for missed sessions. Child is not guaranteed a spot in the program until this form is filled out completely and $50 deposit is made. There will be no refunds or credits given unless BIGEL MUSIC cancels a session and the child cannot be put in an alternate session.

Please check the box to agree to the above waiver: I agree Please agree to the waiver.

Date (mmddyy):