Clone of 2025 - 2026 SMPLA Annual Registration Form

This SECOND SEMESTER Registration form is for the SMPLA “Suzuki Ensembles” program 2025-2026 season.

SUZUKI ENSEMBLES Program:
♥ Violin, Guitar, Cello, Viola, Bass – All ages and abilities are invited.
♥ “Open Door” policy – all students are welcome, regardless of which private teacher they
study with.
♥ Repertoire: Classical music (Bach, etc.), Movie Tunes, Fiddle, World Music, and
special arrangements of Suzuki repertoire.
♥ Three Rehearsal Workshops and One Concert

Rehearsal Workshops: April 6th and 20th, May 11th (Mondays, 5:45 – 7:10 pm)

Concert: May 18th

PLEASE SUBMIT ONE FORM PER STUDENT.

SMPLA CORE ACTIVITIES include: Rehearsal Workshops, Spring Solo Recital, Public Performances (Senior Living Center, Parks, etc., Parent Support Forums, and other musical opportunities)

Please mark your calendars for a special off-site event. Registration coming soon!

Saturday, April 25th – Senior Living Center
(in the San Fernando Valley area)

Student Name*

First NameLast Name

Gender*

Birthday*

MM/DD/YYYY

Parent 1 Name *

First NameLast Name

Parent Email*

example@example.com

Parent 2 Name (optional)

First NameLast Name

Additional Email (optional)

example@example.com

Primary Mobile Phone*

XXX-XX-XXXX

Secondary Mobile Phone

XXX-XX-XXXX

Street Address*

City*

Zip Code*

YesNo

SMAC Teacher*

Name of Teacher*

First NameLast Name

TEACHER Email*

example@example.com

Primary Mobile Phone*

XXX-XX-XXXX

Instrument*

Most Recent Book / Piece being learned*

Questions/Comments

Please review the 'Photo & Video Release for Minors' agreement, then make a selection below.

Photo & Video Release for Minors Photo & Video Release Denied

I understand and agree to the Photo & Video Release for MinorsI understand and will abide by the terms of the Photo & Video Release Denied

You are required to read the following information carefully and make sure that you understand it fully and agree to it before allowing your child(ren) to participate in this activity or program.

Code of Conduct Liability & Medical Waiver

I have read, understand and accept the Code of Conduct and Liability & Medical Release.

My Products*

SMPLA Suzuki Ensembles, April-May 2026. $124.20 (prorated)$124.20

Three Workshop Rehearsals, One Concert during the second semester session of the 2025-2026 season.

SMPLA Red Tie$16.05

For Public Performances & Concerts

SMPLA T-Shirt!$19.16

SMPLA T-Shirt

CHECK THE BOX ABOVE and then select size hereSize

SMPLA Parent Education Seminar "Motivate and Mentor" $57.50

PARENT Education Seminar four-week Seminar will be held virtually in the Spring of 2026.

I love SMPLA and want to support Music Education (choose donation amount below)$ Free

This is a tax-deductible donation to SMAC, a 501(c)(3) non-profit organization. My donation will be directed to support SMPLA music education. CHECK the box above and select your amount below. Please choose a donation amount.

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Total $0.00

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