Impact POP! Spring Session 2023 - Island Music Guild
Saturdays, May 20th - June 17th - Intro to Rock Class: 10 - 11am, Intermediate/Advanced Rock Class 11am - 1pm, Ages 10-18, at Island Music Guild
Student Information
Student's Name
First Name
Last Name
Age
Musical Instrument(s)
Please describe the student's musical background
Parent/Guardian Information
Name
First Name
Last Name
Cell Number
Please enter a valid phone number.
Email
example@example.com
Emergency Information
Emergency Contact's Name
First Name
Last Name
Relationship
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Other
Phone Number
Please enter a valid phone number.
Alt. Phone Number
Please enter a valid phone number.
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement
I hereby give my approval for my child’s participation in any and all activities during the selected class. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Island Music Guild and all its respective coaches and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected class sessions. In case of injury to said child, I hereby waive all claims against Island Music Guild, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.
My Products
prev
next
( X )
Intro to Rock Class
For students who have started taking lessons and are eager to learn songs in an encouraging, collaborative environment
$
60.00
Quantity
1
2
3
4
5
6
7
8
9
10
Intermediate/Advanced Rock Class
Students who can play at least a few songs and are ready to expand their skills
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Submit
Should be Empty: