2019 ChiMOP Mary Lyon Youth Orchestra Registration Contact information
Open to all current ChiMOP members. 3:30 to 5:30 PM. 3rd and 4th grade students attend Monday, Tuesday, Wednesday and Friday. 5th grade and up attend Monday, Wednesday, Thursday and Friday. Starting date: Monday, October 21st.
Student's first name *
Your answer
Student's last name *
Your answer
Parent/Guardian 1 first name *
Your answer
Parent/Guardian 1 last name *
Your answer
Parent/Guardian 2 first name *
Your answer
Parent/Guardian 2 last name *
Your answer
Email *
Your answer
Home Address (Street) *
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City *
Your answer
State *
Your answer
Zip code *
Your answer
Phone number *
Your answer
Grade level *
Your answer
Classroom number *
Your answer
Classroom teacher *
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Experience in ChiMOP? *
Instrument *
Do you own an instrument? *
Are you enrolled in other after school programs? *
If yes, what other after school programs?
Your answer
Does your child have any allergies? (Please list here) *
Your answer
Does your child have permission to walk home by herself/himself? *
Please write the names of people allowed to pick up your child after program *
Your answer
Can you attend our parent meeting on Monday, September 30th at 5:30 p.m.? *
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