Rock Band Enrollment Form

“Give me the beat to free my soul"

Do you remember the first time you experienced music that shook you to your core? "Rock Band!" is a place where kids can be free to be who they are. No apologies. No "quiet down". Just rocking out.  This small group learning environment is a social experience encouraging students to create, manage, and develop their very own band. Students will learn Piano, Guitar, Drums, Vocal Skills, and even create their own songs! Sessions run for 6 consecutive weeks.

Cost is $110 for 6 weeks!

SUMMER SESSION: 7/8- 8/16


LOCATIONS:

Care-a-lot Grand Island
Ages 3-5
Fridays 2:30-3pm

Bloom Early Learning Center- Hamburg
Ages 3-5
Wednesdays 2:30pm-3pm


One payment of $110 is due by the first class and will be invoiced through Quickbooks.

A late payment fee may be assessed for outstanding balances.
Children are expected to attend weekly, and missed sessions will not be reimbursed.
Music runs for 6 weeks, 30 minutes per week.

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Please confirm the location you are registering for: *
Child's Name *
Date of Birth *
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Address *
Main Phone Number *
Secondary Phone Number (If applicable)
Email *
What is your preference? *
Please list Parent/Guardian names below.
Music addresses many different areas of development. Please indicate any areas of need, or areas you would like to work on with your child, and detail any additional information. Examples may be counting, colors, balance, clapping, etc.  
Social/Emotional: Peer play, attention to task, impulse control, cooperative play, engaging in activities, etc:
Motor: Fine and gross motor skills such as grasp (pincer/palmer), balance, coordination:
Communication: effective expressive language skills, volume and tone, articulation:
Academic: Pattern recognition, following multi-step directives, math concepts:
Recreation: Enjoys music, dancing, sings, hums, previously participated in music, etc.
By signing below I acknowledge the above payment and attendance policy. *
How did you hear about us?
Bloom Creative Arts sends newsletters to caregivers highlighting progress and uses photos from weekly sessions. Sharing photos on our social media pages and www.bloomcreativearts.com allows relatives to view the fun we engage in at class. Please indicate below your preference for photo release permission. Contact Information: info@bloomcreativearts.com (716) 422-0070 *
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