Registration Form

Child's First Name*

Child's Last Name*

Child's Date of Birth (dd/mm/yy)*

What are your child's areas of strengths?*

What do you hope to get out of this class?*

Parent's Name*

Email*

Best contact phone number*

Best contact email address*

During the school year what programs do you attend?*

Please describe their musical ability Select One Never participated in any form of organized music group Has basic musical understand Can read music notationa nd rhythms Fluently understands/plays music

Is there anything else you feel Prelude Music should know about your child?

How did you hear about Prelude Music?* Select One Return Sibling Groupon Winnipeg Baby and Kids Show Online search Nest Family Centre Friend (please name in Other text box below) Returning student Walked by in the mall Other

If other, please specify