BMS - Registration Form SUMMER 2024

BALTIMORE MUSIC SCHOOL

SUMMER 2024 Registration FORM: June 15 - August 11
Student Last Name*
Student First Name*
Student D.O.B.*

MonthDayYear
Date
Address*
City*
State*
Zip*
Home Phone Number*

Area CodePhone Number
SMS/Texts Number

Area CodePhone Number
Parent 1 - Name*
Parent 1 Cell Phone*
Parent 1 -Work Phone
Parent 1 - Email Address*
example@example.com
Parent 2 - Name
Parent 2 - Cell Phone
Parent 2 - Work Phone
Parent 2 - Email Address
example@example.com
Student Status:*
Check Your Summer Selection:

5 weeks x 30 min Private Lessons $2555 weeks x 45 min Private Lessons $3705 weeks x 60 min Private Lessons $4757 weeks x 30 min Private Lessons $3607 weeks x 45 min Private Lessons $5107 weeks x 60 min Private Lessons $630
Instrument for 5 weeks x 30 min:*
Instrument for 5 weeks x 45 min:*
Instrument for 5 weeks 60 min:*
Instrument for 7 weeks 30 min:*
Instrument for 7 weeks 45 min:*
Instrument for 7 weeks 60 min:*
Total Due:
(Auto-Calculated based on your selections)
REGISTRATION OPTIONS:

1) By Zelle: Email Registration Form to music@bmsmd.org. Send funds by Zelle transfer to music@bmsmd.org

2) In-Person: Bring Registration Form with payment to class, cash or check payable to “Music School”.

3) By Email: Email Registration Form and a photocopy of both sides of written check to music@bmsmd.org
I consent and agree that above student's name, picture, voice, or video may be used by Baltimore Music School for school publications, on the school Internet website, in school-related videos, or for news and other publications. I hereby release Baltimore Music School and all of its officers, directors, and employees from all liability for personal injury, illness, or property damage occurring on or Baltimore Music School premises. I have read, understand, and agree to all Baltimore Music School Policies and Procedures published at http://bmsmd.org
Parent Signature:*

Clear
Date:*

MonthDayYear
Date
Should be Empty:

BALTIMORE MUSIC SCHOOL