Spring Valley Piano Lab Registration 2023-24
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Welcome to Gilmore Piano Lab at Spring Valley Elementary --

Piano Lab begins September 18th-- Students will have varying start dates according to their individual schedules.

Please complete this registration form BY FRIDAY, SEPTEMBER 15, 2023.  You may also choose to complete a paper registration form and return it to your school office by the same date.

The Gilmore is pleased to offer a new PAY WHAT YOU CAN fee for Piano Lab this year with a SUGGESTED PAYMENT OF $25 per student. Any amount is welcome and will not impact your ability to be registered.

After you submit this form, you will have the option of paying online. We can also accept cash, check or money order made payable to The Gilmore. 
 
If you send a payment to school, remember to seal your payment in an envelope and write PIANO LAB, your STUDENT NAME, and their CLASSROOM TEACHER on the front.

Registration and payment can also be mailed to:
THE GILMORE, ATTN: PIANO LAB, 359 S. KALAMAZOO MALL, SUITE 101, KALAMAZOO, MI 49007-4843


*AFTER-SCHOOL PIANO IS CURRENTLY ON HOLD. If you're interested in participating in After-School Piano, please check the box in the registration form below.  We'll contact you when we have more information about the program.


Questions? 
Liz Kelly, Education Coordinator | LKelly@thegilmore.org
Adam Schumaker, Director of Education | ASchumaker@thegilmore.org
Leslie Baron, Education Manager |  LBaron@thegilmore.org

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Email *
Is your student new to Piano Lab or returning?  *
Student First Name  *
Student Last Name  *
Preferred Name 
Pronouns *
Write in pronouns if needed 
Student Age *
Birth Date (MM/DD/YY) 
Classroom Teacher
Grade in School *
Student's KPS student email address for use in Google Classroom
Student owns or has access to a piano/keyboard on a regular basis?
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If yes, what kind of piano?
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PARENT/GUARDIAN INFORMATION
Parent/Guardian First Name *
Parent/Guardian Last Name  *
E-mail address  *
May we text your cell phone number?  *
Street Address *
City  *
State *
Zip Code  *
Home Phone (land line)
Work Phone 
Cell Phone *
Emergency Contact First Name *
Emergency Contact Last Name  *
Email Address *
May we text your cell phone number? *
Street Address
City and State 
Zip Code 
Home Phone
Work Phone 
Cell Phone 
Are you interested in After-School Piano if the program is offered later this year? *
Keys2Kids Keyboard Lending Program Information
The Keys2Kids Keyboard Lending program is for students participating in Piano Labs who do not
have an instrument at home for practice. The Gilmore can lend one (1) keyboard per family, free of charge, while students are participating in the program. Families who choose to participate will
receive a keyboard and full details after registration, while supplies last.

Keys2Kids Keyboard Lending
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In consideration for being allowed to participate in the Gilmore Keyboard Festival’s programs, I agree to assume the risk of such activities and programs; and I further agree to hold harmless The Gilmore and its staff members conducting the activities from any and all claims, suits, losses, or related causes of action for damages including out-of-school trips by van or bus, understanding that competent leadership is provided. The Gilmore is not responsible for lost, stolen, or damaged personal articles. I also authorize The Gilmore to have and use music composed by my child, photographs, and audio and/or video recordings of me, my child, or family as may be needed for public relations programs. I acknowledge that this General Release of Liability is binding on me, my representatives, and program participants.
PARENT or GUARDIAN SIGNATURE  *
DATE  *
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