Fiddlehead New Music Registration
Please fill out a separate form for each student attending a program with us.
Email address *
Participant Information *
Please type the student’s full name  
Your answer
Student's date of birth   *
MM
/
DD
/
YYYY
Student's Gender *
School Attending (if applicable)
Your answer
Grade
Parent/Guardian Full Name
Adult students can skip this question
Your answer
Relationship to student:
Your answer
Home Address *
Please include: Street Address, Town, State and Zip Code
Your answer
Cell Phone *
Your answer
Home Phone
Your answer
Work Phone
Your answer
Alternative Parent Email
Your answer
Would you like to add the contact information for an additional parent or guardian? *
Are there any other adults allowed to pick up the minor student from music lessons? *
Required
Please list the name(s), contact phone, and relationship to student for ALL adults who have permission to pick up child from class or camp at Fiddlehead.
Fiddlehead will not release students to any adult who is not a parent/guardian or a guardian on this approved list. Parents can also provide proper authorization by calling Fiddlehead staff when needed.
Your answer
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