Registration: Brigitte’s Artistic Camp

Brigitte’s Artistic Camp

REGISTRATION: all students 

Student’s first and last name:                                                                        Date of birth:

Program chosen:

School:

Parents’  names:

Address (with postal code)

Phone numbers:

E-mail addresses:

Will you need before and after care?               Please add 15$ for the week

Allergies:

In case of emergency phone nu. :

If need be on a rainy day, do you allow your child to watch a movie at the end of the day?

STRINGS AND HARPS PROGRAMS (please fill in)

Instrument:                        Years of playing:

What pieces, scales and studies did you play this year:

Teacher’s name and phone no.

Your sight reading is (circle): Very good, good, just starting, not yet

Are you preparing an exam? If yes, what grade?

WHICH GROUP are you registering for (please add letter for strings):

Do you own your instrument?

Will you take private lessons (circle): yes, no /If yes, choose how many:

1×30 min. = $20 (strings) 30$ (harps) / 1×45  min.= $30 (strings) 45$ (harps)

2×30 min. = $40 (strings) 60$ (harps) /  2×45 min. = $60 (strings) 90$ (harps)

3×30 min. = $60 (strings) 90$ (harps) / 3×45 min. = $90  (strings) 135$ (harps)

4×30 min. = $80 (strings)  120$ (harps) / 4×45 min. = $120 (strings) 180$ (harps)

For more information or questions, don’t hesitate to call me at 776-1026 or e-mail me at brigitteamyot@gmail.com

Please return this form with your payment to: Brigitte Amyot, 284 Boul. Riel, Gatineau, J8Z 1A9 (registration: 35$ + camp 230$ = 265$) lessons:  _   / before and after care: 20$ (Cheques post-dated to April 1st are accepted)

or by e-mail to brigitteamyot@gmail.com / e-transfers are accepted.