Harmony Lounge & Music Club - Registration Form

Student Registration Form
Harmony Lounge & Music Club is a not-for-profit community program of St. Mary Magdalene Anglican Church for students aged 12 to 16 in Napanee and surrounding communities.
- Group classes are taught by professional faculty.
- Private lessons are taught by student/co-op teachers.
- There are no fees to register for any Harmony programs.
- Instrument loans will be arranged wherever possible.
- Please complete the form and our registrar will be in touch to confirm your private lesson time slot.
2024 Fall Session Schedule is 8 weeks beginning the week of October 7. A full calendar, including concert dates, will be emailed to you after registration.
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Student Name*

First NameLast Name
Student Phone*

Area CodePhone Number
Student Email*
example@example.com
Student Date of Birth*

MonthDayYear
Student's Grade

678910Other
School Currently Attending

J.J. O'NeillSouthviewPrince CharlesNDSSHoly CrossOther
Private lessons are 30 minutes long and are taught by student teachers. Group lessons are 1-hour in length and are taught by our professional faculty. We strive to offer every Harmony student 1 group class and 1 private lesson.
TUESDAYS

3:00 to 4:00 Private Drum Lessons4:00 to 5:00 Group Percussion Class5:00 to 6:30 Rock Skool Group 1 - Audition Required6:30 to 8:00 Rock Skool Group 2 - Audition Required
For private lessons, please indicate a preferred time slot or range.
Preferred time slot/range
WEDNESDAYS

3:00 to 6:00 Private Guitar Lessons3:00 to 6:00 Private Drum Lessons4:00 to 5:00 Group Voice5:15 to 6:15 Group Violin (Instruments provided)
For private lessons, please indicate a preferred time slot or range.
Preferred time slot/range
THURSDAYS

3:00 to 6:00 Private Drum Lessons4:00 to 5:00 Group Guitar Level I, Beginner
For private lessons, please indicate a preferred time slot or range.
Preferred time slot/range
Do you require an instrument?

YesNo
It's not necessary, but does this student have any previous musical experience?

YesNo
Are there any medical needs that may arise during this student's lessons?*

YesNo
Would your student like to discuss volunteer hours/leadership training opportunities?

YesNo
Please describe*
ATTENDANCE

All group and private lesson spaces at the Harmony Lounge & Music Club are free to students, but are generously funded by community grants. Spaces are limited, so if you do not anticipate your student being able to attend the majority of their lessons/classes, please do not register at this time.

LIABILITY

The undersigned gives permission for his or her child/children to participate in the above named activity and releases Harmony Lounge and Music Club, its officers, employees, and agents from any liability whatsoever for any injury or death to person or loss or damage to property sustained by the undersigned for any member of his family, in attendance, and the undersigned agrees to defend and indemnify the Church of St. Mary Magdalene, its officers, employees, and agents from any liability or loss they might sustain by reason thereof.

I hereby grant permission to Harmony Lounge & Music Club to use photographs and/or video of my child/children taken in the above-named activity in publications, news releases, online, and in other communications related to the programs of Harmony.
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Student Registration Form