STRINGS REGISTRATION FORM
This information is collected under the Municipal Freedom of Information and Protection of Privacy Act.

Program Information:
The Hamilton Wentworth District School Board Strings Instruction Program is offered through Community Continuing Education. The Strings Program provides an opportunity for children enrolled in grades 4 to 8 attending HWDSB schools to learn to play the violin or cello. This program is a fee-for-service program and fees are payable at the time of registration.
Lessons are taught in the students’ home school once a week during the instructional day which means lessons may occur during regular class time, nutrition breaks or lunch break. If we do not have enough registrations at a school, there is the option of your student taking lessons at Nora Frances Henderson Secondary School on Wednesday evenings.
For an added fee, there is an opportunity for your child to play in an Orchestra. This enhances the skills learned in the regular lesson and prepares students for future violin or cello success!
Fees are for 30—1/2 hour lessons. If you add orchestra, your child is then going to have an additional 30—1 hour long orchestra classes!
INSTRUMENTS ARE PROVIDED AT NO COST!
MUSIC BOOK INCLUDED! All students will receive a music instruction book relevant to their own level to use and keep!!
There are two concert opportunities (one in winter and one in spring) for all students enrolled in the Strings Program!
See www.hwdsb.on.ca/cce/strings for full program information, fees and payment schedule.

STUDENT LAST NAME *
Your answer
STUDENT FIRST NAME *
Your answer
Instrument *
Returning or New Student? *
Lessons Only? (No Orchestra) *
Orchestra (weekly lesson + weekly orchestra) *
Private Lessons ? *
Group Lessons ? *
Orchestra Level *
Gender *
Date of Birth *
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DD
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Grade in 2017/2018 *
Home School *
Home Phone Number *
Your answer
Cell Phone Number *
You can enter N/A if you do not have a cell phone.
Your answer
Work Phone Number *
Your answer
Home Address - Unit Number/House number and Street Name *
Your answer
City *
Postal Code *
Your answer
Name of Parent / Guardian *
Your answer
Emergency Contact Person *
Your answer
Emergency Contact Phone Number *
Your answer
Medical Concerns *
Medical Description *
Please enter Not Applicable if there are no medical concerns
Your answer
Home Email Address *
Your answer
Alternate Email Address
Your answer
Consent to Photograph and Videotape *
In accordance with the Municipal Freedom of Information Act, 1989, I consent to have my child's photo used in media stories (including TV, newspaper) and/or Board publications, website or videos.
Lesson Location Preference *
Special Notes:
If you have any comments or special requests, please enter them here.
Your answer
PLEASE PRINT - please enter your initials to acknowledge *
Please print a copy of the "Payment Form 2017-2018", complete it and submit the form with payment to Red Hill Learning Centre - Strings Program, 300 Albright Road, Hamilton, ON L8K 5J4. After August 31, 2017, please mail to Hill Park Learning Centre, 465 East 16th Street, Hamilton, ON L9A 4K6
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Authorization - by entering my initials below I confirm that I am authorized to register this child for the CCE Strings Program. *
Enter your initials below
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