JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Registration Form: Build Your Own Ukulele Kit (July)
Please complete the following registration form to sign up for one of our July At Home Music Kits!
If you are registering more than one child, please complete ONE FORM PER CHILD.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
PARTICIPANT INFORMATION
First Name
*
Your answer
Last Name
*
Your answer
Birth Date:
*
MM
/
DD
/
YYYY
PARENT / GUARDIAN INFORMATION
First Name:
*
Your answer
Last Name:
*
Your answer
Phone Number:
*
Your answer
Email Address:
*
Your answer
BUILD YOUR OWN UKULELE KIT
Level Requested:
*
Primary Level (ages 5-11)
Secondary Level (ages 12+)
Pick Up Date Requested (190 Lester St, Waterloo):
*
July 6, 2020 at 4pm
July 7, 2020 at 10am
I am unavailable for both pick ups and will need to arrange an alternate pick up time.
My child is interested in joining the online group meeting at the end of July to share their creation!
*
Yes
No
ADDITIONAL AT HOME MUSIC KITS
If you have other children who are not registered for lessons, but are interested in a Build Your Own Ukulele Kit, please indicate below. We will be in touch to confirm availability.
Please list full names and ages of children interested in additional kits:
Your answer
Parent / Guardian Signature:
*
Your answer
Date:
*
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Community Music School of Waterloo Region.
Report Abuse
Forms
