Fall Session Registration

Child's Name *

First

Last

Elementary School *

Grade *

Gender *

Birthday *

Please select ALL the practice times that work for you. We try to dedicate certain groups to certain age groups so the more flexibility you have the better. However, if you can only do one practice time that's okay too. We will work to get your Skunker grouped with other kids their age. *

(1) Parent / Guardian *

First

Last

Email *

Phone *

Is it okay to receive text messages on the phone number provided above? *

Address *

ZIP code *

(2) Parent / Guardian *

First

Last

Email *

Phone *

Is it okay to receive text messages on the phone number provided above? *

What are you and your child's goals or expectations for the program? Prior musical experience/ interest? Instruments you have at home? Family history with music? Favorite song?

Is your child left handed, right handed, ambidextrous?

Please describe any pertinent allergies. We serve a snack of organic popcorn with butter and salt, baby carrots, oranges and bananas. We also have a few studio cats but they usually stay upstairs and out of the way.

Registration Fee: If there is a spot available for my child I agree to pay the registration fee of $30. This covers the cost of our secure payment system and includes a performance trophy at the end of the session. *

I agree.
I would like more information.

Weekly Fee Agreement: I understand the session is 18 weeks and I will be billed $34 a week, per child, every Friday for the total weeks in the session –– unless (of course) the program is not working for me or my child for any reason. *

I agree.
I would like more information.

Attendance Policy: If my child misses a practice I understand I will still be billed the $34.00 a week; however, I also know that my child can makeup a missed practice any other day of that week or the following weeks as many times as they need per week. *

I agree.
I would like more information.

Photo and video / audio recording release: I give permission and consent to Skunk Rock to make, reproduce, and edit video film, footage, sound track recordings and photo reproductions of my child for legitimate business uses. Skunk Rock may take photos and video of my child. These may be used at Skunk Rock websites, parent and community materials, and social media posts. *

Yes
No
I would like more information.

How did you hear about us? *

Please include any questions or comments here.

Fall Session Registration

No payment info needed until your spot is confirmed.

Thank you for signing up! We will reach out soon to confirm your spot!