Woods Lake 2019-2020 Piano Lab Registration
Woods Lake - A Magnet School For The Arts

In-School Piano Labs begin September 23. After School Piano begins September 30, for which you will receive an email confirmation.

PLEASE COMPLETE AND RETURN REGISTRATION FORM AND $15 FEE TO YOUR SCHOOL OFFICE BY FRIDAY, SEPTEMBER 27, 2019. ADD $5 TO FEE IF YOU CHOOSE AFTER-SCHOOL PIANO, FOR A TOTAL OF $20.
(Cash, check or money order payable to The Gilmore, in an envelope, with the student's name on the front.)

Payment plans are available. Call Adam Schumaker at The Gilmore, 269.342.1166.

Registration and payment can also be mailed to:
THE GILMORE, ATTN: PIANO LAB, 359 S. KALAMAZOO MALL, SUITE 101, KALAMAZOO, MI 49007-4843

Once you submit this form, you will have the option of paying online.
Student First Name *
Your answer
Student Last Name *
Your answer
Preferred Name
Your answer
Student Age *
Your answer
Birth Date (MM/DD/YY)
Your answer
Classroom Teacher
Your answer
Grade in School *
Your answer
Student owns or has access to a piano/keyboard on a regular basis?
If yes, what kind of piano?
PARENT/GUARDIAN INFORMATION
Parent/Guardian First Name - Apellido de padre *
Your answer
Parent/Guardian Last Name *
Your answer
E-mail address *
Your answer
Do you use text messaging? *
Street Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Home Phone (land line)
Your answer
Work Phone
Your answer
Cell Phone *
Your answer
Emergency Contact First Name *
Your answer
Emergency Contact Last Name *
Your answer
Email Address *
Your answer
Do you use text messaging *
Street Address *
Your answer
City / State
Your answer
Zip Code
Your answer
Home Phone
Your answer
Work Phone
Your answer
Cell Phone
Your answer
After-School Piano Registration *
After School Piano information
After-School Piano (ASP) practice sessions are divided by grade and run from 3:45 to 5:00 PM. Participating students will have the option of eating a free after-school meal, provided by Communities in Schools.

Bus transportation is not provided. Parents must pick up students by 5:30 PM.

Students are expected to attend their assigned day each week that the program is in session.
Grades 4-5 meet on Monday / Grades 3-4 meet on Tuesday / Grades 2-3 meet on Wednesday

STUDENT ASSIGNMENT CONFIRMATION WILL BE SENT HOME BEFORE THE PROGRAM BEGINS.
PLEASE DO NOT SEND YOUR STUDENT TO ASP IF YOU HAVE NOT RECEIVED CONFIRMATION.
In consideration for being allowed to participate in the Gilmore Keyboard Festival’s programs, I agree to assume the risk of such activities and programs; and I further agree to hold harmless The Gilmore and its staff members conducting the activities from any and all claims, suits, losses, or related causes of action for damages including out-of-school trips by van or bus, understanding that competent leadership is provided. The Gilmore is not responsible for lost, stolen, or damaged personal articles. I also authorize The Gilmore to have and use music composed by my child, photographs, and audio and/or video recordings of me, my child, or family as may be needed for public relations programs. I acknowledge that this General Release of Liability is binding on me, my representatives, and program participants.
PARENT/GUARDIAN SIGNATURE *
Your answer
DATE *
MM
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DD
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YYYY
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