Kamloops Symphony Music School Registration Form

Please fill out the form below to register for private lessons or classes. If you would prefer filling out a digital copy, or printing it out, a pdf version of the form can be found here.

Due to the change in our school software so that we may grow with you, we ask for your patience during this transition. At this point, we will take registrations and early registration payments. However, we will not be processing invoices or payments for anything other than the early registrations at this time. Anyone taking summer lessons is also asked to be patient, as this falls into our new year (July 1st). We look forward to what September will bring!

Please note that an additional form is required for those registering for MYC classes. Please contact the office at 250-372-5000 for more information.

Student Information

* Student's Name

* Date of Birth (e.g. March 7, 1997)

* Home/Primary Phone

Cell Phone

Work Phone

* Email

Mailing Address

* Street Address

* City

* Province

* Postal Code

* I would like to be added to the Kamloops Symphony E-Newsletter Mailing List Yes
No

Parent/Guardian Information

Parent/Guardian Name 1 (if applicable)

Mailing Address (If different from above)

Home/Primary Phone

Cell Phone

Work Phone

Parent/Guardian Name 2 (If applicable)

Mailing Address (if different from above)

Home/Primary Phone

Cell Phone

Work Phone

Lesson/Class Information

* Instrument or Class

Teacher

* New or Returning Student? New Student
Returning Student

Preferred Day

Preferred Time

* Length of Lesson 30 minutes
45 minutes
60 minutes

* Frequency Weekly
Bi-weekly

Instrument or Class

Teacher

New or Returning? New Student
Returning Student

Preferred Day

Preferred Time

Length of Lesson 30 minutes
45 minutes
60 minutes

Frequency Weekly
Bi-Weekly

General Information & Policies

Please read the Kamloops Symphony Music School's General Information & Policies for all students and parents/guardians here.

Please read the Kamloops Symphony Music School's Student & Parent/Guardian Code of Conduct Policy here.

Please read the Kamloops Symphony Music School's Student & Parent/Guardian Health & Hygiene Policy here.

* To be completed by the Student: (or by Parent/Guardian if the student is under the age of 18): I acknowledge and agree to be responsible for my safety (and the safety of my child) while on the premises of the Kamloops Symphony Music School. Further, I accept responsibility for damage caused to the facility by my actions (and those of my child) and agree to indemnify the Kamloops Symphony Music School for any damages arising as a result of those actions. Yes

* I have read and agree to adhere to the General Information & Policies above: Yes

* I have read and agree to adhere to the Student & Parent/Guardian Code of Conduct above: Yes

* I have read and agree to adhere to the Student & Parent/Guardian Health & Hygiene Policy above: Yes

* I agree to receiving monthly informational newsletters pertinent to the KSMS: Yes

* Your Name: