Advanced Rock Band - Kaleidoscope Rock Academy

Name*
First Last
ROCK ELITE band*
- F
- G
- I
- K
- L
- N
- O (formerly PURPLE)
- don't know which I am! (that's OK)
- new to the program (assign me a band!)
Instruments Played (check all that apply)*
- Guitar
- Drums
- Voice
- Bass
- Keys/Piano
- Ukulele
- Other
Name of Private Teacher (if you have one)
Email address of Private Teacher
Parent(s)' Name(s)*
Mailing address for communications*
Street Address Address Line 2 City State ZIP Code
Cell Phone (parent 1)*
Cell Phone (parent 2)*
Cell Phone (student)
Email*

Parent 1 or self
Email (parent 2)
Email (student)*
Email (other)
How you heard about Kaleidoscope*
Comments about schedule, or any other concerns
Tuition and Participation Commitment
Rehearsals, song choices and public performances for the academic year are all highly customized to meet the needs of students who join Rock Elite each Fall. Rock Elite bands are a team of select individuals and the program is designed each year around that specific team. When students drop out mid-year, it can severely impact the success and enjoyment of all band members.

By registering and paying Fall/Winter tuition, band members and parents of those members are committing themselves to paying second and third trimester tuition in full and participating in the program through the following October. (Seniors going out of the area for college can be prorated at 66% for the third trimester.)

No refunds are given on Rock Elite tuition for students dropping out mid-year. If a class is canceled by the instructor, tuition will be refunded in full
*
- Yes, I agree to the policy
I understand and agree to the Tuition and Participation Commitment Policy. I understand that I am committing my student to participating for the entire academic year (Fall to Fall) and I am committed to paying for November 2019 through October 2020 (billed in three segments). My signature below applies to both the Tuition and Participation Commitment and to the Photo / Video Release.
Tuition Commitment and Photo/Video Release Form
I hereby grant permission to Kaleidoscope School of Music, LLC and any of its programs (such as Kaleidoscope Rock Academy) to photograph or video my student / Rock Elite participant during any activities (including rehearsals, lessons and performances) and to use these photographs and videos in Kaleidoscope School of Music audio-visual, online and printed materials (including social media) without compensation or approval rights.

If the participant is a returning member of any Kaleidoscope School of Music / Kaleidoscope Rock Academy program, I grant permission to Kaleidoscope to use any past videos and photos in the aforementioned fashion.
*
- Yes, I agree to the policy
I understand and agree to Photo/Video policy. My signature below applies to both the Tuition and Participation Commitment and to the Photo / Video Release.
Signature*
Use your mouse or touch screen to sign that you agree
1st Trimester 2019-2020 ELITE

Tuition: $295
Tuition Deadline: August 29, 2019
Method of Payment*
- Check
- Paypal
Total
$0.00
Email
This field is for validation purposes and should be left unchanged.

Tuition and Participation Commitment

Tuition Commitment and Photo/Video Release Form

1st Trimester 2019-2020 ELITE