Altitunes Registration Form

Please fill out a separate form for EACH child.

Classes are led and designed for kids of all developmental stages by a teacher who is a Board-Certified Music Therapist and a Neurologic Music Therapist.

*That being said, knowledge is power, and who knows your child's likes, dislikes and sensitivities better than you do? Be as thorough as you are able, because we are able to use what you share with us about your child to immediately increase their level of comfort in class.
We are also able to be more prepared with adaptations to set your child up for success, and implement them more subtly in a group setting.

**Completed registration forms are MANUALLY entered into the Mindbody system, which is why you SHOULD NOT EXPECT a welcome email with your username and password instantly.

We will most likely input your registration information into the Mindbody computer system within 48 hours.

If you plan on attending a music class, but are still waiting on the arrival of your welcome email please RSVP via:
Text: 970-231-5456
Email: m.hopkins@altitunes.net
Facebook: www.facebook.com/altitunes

Once you have received your username and password then all RSVP's should be done by logging in at:
mindbody.altitunes.net

Please plan on bringing socks for everyone that will be coming into the classroom.

****ONLY NEED TO COMPLETE FORM ONE TIME****

*******MUST BE COMPLETED by the child's LEGAL GUARDIAN**********
(not a nanny/other family member)

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    Waiver of Claims and Release of Liability

    To the best of my knowledge, all information provided above is accurate, and unless otherwise noted in detail under “Special Information,” my child has no physical, emotional or social conditions which make it dangerous for him/her to participate in music program activities with ALTITUNES Neurologic Music Therapy. If any of the information I have stated on this form about my child changes, it is my responsibility to provide ALTITUNES Neurologic Music Therapy with those changes. I hereby give my permission for my child to participate in all music related programs provided by ALTITUNES Neurologic Music Therapy, and I hereby release and save harmless Maureen A. Hopkins and ALTITUNES Neurologic Music Therapy from any and all liability and claims which may arise from me and my child’s participation in music classes, music therapy and/or other events provided by ALTITUNES. The child’s parent/legal guardian is required to type a simple, electronic signature (not an encrypted, digital signature), followed by the date, in order to participate.
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    By typing your name, followed by the date, on this form you are indicating that you are the parent/legal guardian of the child named on this form, and that you accept and acknowledge ALTITUNES Neurologic Music Therapy's stated policies and conditions for participation

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