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Information/Questionnaire/Registration for the JAM Kids of Henderson County

Information re Registration for Fall 2025/Spring 2026

Fill out once for EACH child:

1. RETURNING STUDENTS, Fill out appropriate parts of the form below for each student and email to me. Note any time parameters or changes of contact, address. We will update the annual instrument agreements when school begins.

2. IF NOT RETURNING, please let me know. We need your loaner back asap & will miss you.   

3. NEW OR INTERESTED STUDENTS, We’ll need to know about your child so please fill out the WHOLE FORM below. Students are generally 8 years of age or turning 8 during the upcoming year. (We do on occasion make an exception but maturity is important.)  

JAM Kids is a national program and there is much more information on the national website at www.jamkids.org. Feel free to email me with any questions at fbvmamail@gmail.com. Thank you - Carol Rifkin

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Is your student a:
Parent Last Name
Student Street Address
City
State
Zip
Phone
Email
Student 1 info: Name
Age
Birthdate
MM
/
DD
/
YYYY
Grade Level
School
Name of School
Does He/She have an instrument? (Advanced students only- who wish to play two instruments- must check both sets of boxes below.
Check one box for your child's first choice of instrument to play. Advanced students only may also select an additional instrument and check two boxes. 
Are they applying for a loaner instrument: (If so, we will need to measure the student and complete an annual loaner form.) Everyone should complete the first two boxes. Only advanced students should complete the last two boxes. Contact us if you are not sure or need help with this. 
Is the student:
Will they be able and supported to set aside time each week to practice?
Briefly describe their musical background
What times/days work best for you?
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