Parental Consent & Registration

2018-2019 In-Studio Class Schedule. Please read carefully, complete all fields and return to Quest Center staff or email to jim@qcdickson.org

All classes begin the week of September 10. These are full school-year classes. Semester 2 begins in January 2019 and ends in May 2019. Schedule is subject to change. Additional sessions may be added.

NO CHILD WILL BE TURNED AWAY FOR FINANCIAL REASONS, BUT EVERYONE IS EXPECTED TO CONTRIBUTE. Confidential assistance available, so please contact jim@qcdickson.org.

By submitting this application, you agree: 

1) Unless other arrangements have been agreed, payment is expected MONTHLY IN ADVANCE for student to attend class. Full-semester advance payments are encouraged; refunds will be issued for any missed or cancelled classes. PLEASE NOTE: Payment is expected for any unscheduled absence unless the Quest Center is notified at least 3 hours prior to start of class.

2) Learning to play an instrument requires commitment to practice and hands-on repetition. NO STUDENT WILL LEARN TO PLAY AN INSTRUMENT IN JUST 45 MINUTES PER WEEK. I commit to having my child practice at home, if possible, be present and arrive prepared for all lessons. Out of consideration for all students, anyone who misses 2 consecutive, scheduled classes will be considered terminated for the current semester unless student attends a make-up class.

3) I understand that if student enrollment falls below 4 students, the Quest Center may discontinue program.

4) The QUEST CENTER IS A 501(C)(3) non-profit charitable organization that relies heavily on pictures and videos of our classes/events to build awareness and funding for our programs. I agree that images/videos of my child may be used for Quest Center promotional purposes. 

I WOULD LIKE MY CHILD TO PARTICIPATE IN: *
(SELECT ONE OR MORE CLASSES). Please complete a separate form for each student)
Student Name *
Student Name
Student grade during the 2018-2019 academic year.
Please share any prior experience your child has had with music.
What would you like your child to gain from this experience?
Does your child have any special learning considerations? *
GUITAR STUDENTS: Does your child own or have access to an instrument in good playing condition? *
IF NO... Is your child right handed or left handed?
I UNDERSTAND, AGREE & COMMIT: Name of Parent or Legal Guardian *
I UNDERSTAND, AGREE & COMMIT: Name of Parent or Legal Guardian
By submitting this form, I confirm that all information provided is complete and accurate.
Date *
Date
Mobile Phone *
Mobile Phone
Must be a valid, active & monitored cell phone number.