Registration Form for MUSICAL SUMMER 2010

Student’s Name: ____________________________ T-Shirt Size: (circle one) CS CM CL AS AM AL

Course(s) Registered For: ____________________________________________________

Address:__________________________________________________________________

Email:_______________________ Phone:______________________

Age:____ Birthday (d/m/y)_______ Medical #:___________________________________

Emergency Contact:________________________________________________________

Student’s Experience on Instrument: ______________ Level of Playing: _______________

Special Circumstances that will help us make your summer experience a success: _________________________________________________________________________

_____________________________________________________________________

Summer Registration Deadline: May 25^th

Refunds: For all courses, Partial REFUNDS (less 25% non-refundable cancellation fee) available until June 20^th. Absolutely NO refunds after June 20^th. All course withdrawls must be made in writing on or before June 20^th in order to receive refund.

‘I have read & understand the refund policy.’

Parent’s Signature: ________________________________

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DO NOT SEND CASH IN THE MAIL.

Payment by Cheque or Money Order only. NSF fee for returned cheques $30.

Beginner Violin $100 _____

Victoria Fiddle $300 _____

Busking Sup. Victoria $ 160 _____

Vancouver Fiddle $350 _____

Busking Sup. Vancouver $225 _____

CD Recording Retreat $500 _____

Please make all cheques payable to:

Amy Levinson or Amati String Studio

1660 Earle Street

Victoria BC V8S 1N5

Summer Registration Deadline: May 25^th

Refunds: For all courses, Partial REFUNDS (less 25% non-refundable cancellation fee) available until June 20^th. Absolutely NO refunds after June 20^th. All course withdrawls must be made in writing in order to receive refund.