College-Rolando Satellite Registration Form

Fall Quarter 2021

Use this form to register your family for group music classes at the College-Rolando Library. If you have any questions about the classes listed below, please reach out to Aaron Bullard at abullard@villamusica.org.

Classes run for 10 weeks:

Quarter Starts Monday 9/20

Quarter Ends Sunday 12/5

Parent First Name*

Parent Last Name*

Email*

Phone Number

Postal Code*

Child 1 First Name

Child 1 Last Name

Child 1 Group Class

Violin Dolce, Beginners Ages 5-7 - Wednesdays 3:30-4:00pm

Violin Dolce, Beginners Ages 8-10 - Wednesdays 4:00-4:45pm

Violin Scherzo, Intermediate - Wednesdays 4:45-5:30

Do you agree for your child to be photographed/video-graphed for marketing purposes? Checking the box indicates "yes", leaving the box blank indicates "no".

Child 1 Photography Permission

Child 2 First Name

Child 2 Last Name

Child 2 Group Class

Violin Dolce, Ages 5-7 - Wednesdays 3:30-4:00pm

Violin Dolce, Ages 8-10 - Wednesdays 4:00-4:45pm

Violin Scherzo, Intermediate - Wednesdays 4:45-5:30

Do you agree for your child to be photographed/video-graphed for marketing purposes? Checking the box indicates "yes", leaving the box blank indicates "no".

Child 2 Photography Permission

Child 3 First Name

Child 3 Last Name

Child 3 Group Class

Violin Dolce, Ages 5-7 - Wednesdays 3:30-4:00pm

Violin Dolce, Ages 8-10 - Wednesdays 4:00-4:45pm

Violin Scherzo, Intermediate - Wednesdays 4:45-5:30

Do you agree for your child to be photographed/video-graphed for marketing purposes? Checking the box indicates "yes", leaving the box blank indicates "no".

Child 3 Photography Permission

Child 4 First Name

Child 4 Last Name

Child 4 Group Class

Violin Dolce, Ages 4-7 - Wednesdays 3:30-4:00pm

Violin Dolce, Ages 8-10 - Wednesdays 4:00-4:45pm

Do you agree for your child to be photographed/video-graphed for marketing purposes? Checking the box indicates "yes", leaving the box blank indicates "no".

Child 4 Photography Permission