Get Enrolled

Submitting the following form will initiate the enrollment process.  Acceptance of the HLFMC Policies and Consent to Participate / Waiver of Liability at the bottom of this page is required to submit the form.

    Student Information:
    First Name:*
    Last Name:*
    Date of Birth:*
    Does the student already play an instrument?*
    YesNo
    What instrument is your student interested in learning?*

    Other Instrument (Please specify):

    What school does the student attend?*
    Student Grade:*
    Is your student interested in joining other community orchestra/performing groups?*
    YesNo
    Is your student currently enrolled in an orchestra/performing group at school?*
    YesNo

    Parent/Guardian One Information
    First Name:*
    Last Name:*
    Place of Employment:*
    Occupation:*
    Email:*
    Cell/Primary Phone:*
    Work Phone:
    Home Phone:
    Street Address:*
    City:*
    State:*
    ZIP / Postal Code:*
    Parent/Guardian Two Information
    First Name:
    Last Name:
    Place of Employment:
    Occupation:
    Email:*
    Cell/Primary Phone:
    Work Phone:
    Home Phone:
    Street Address:
    City:
    State:
    ZIP / Postal Code:
    Emergency Contact:
    First Name:*
    Last Name:*
    Relationship to Student:*
    Cell/Primary Phone:*
    Work Phone:
    Home Phone:
    Required: Review the HLFGMC policies and complete the acceptance portion at the end.
    You will not be able to submit the form until this is completed.

    Policies:

    ATTENDANCE

    Absences should be reported to the teacher/administrator at least 24 hours prior to the lesson. Students missing more than two (2) lessons per term without prior notice will be considered unexcused. Students with more than (2) unexcused absences may be withdrawn from the program. No refunds or credits will be considered for unexcused absences.

    TARDINESS

    Parents should contact a teacher or an administrator if their child is going to be late and give an estimated time of arrival. Students who are frequently late to a lesson may be withdrawn from the program.

    PRACTICE

    Students will be provided with a materials folder that will include their music lessons and practice log. Students are required to practice daily on their instruments at home to help achieve musical success. This extra effort and discipline will help the student to show improvement and progress at a faster pace during weekly lessons. Students are required to maintain a monthly practice log to record the date and time spent practicing at home. Students are required to bring the practice log to each music lesson for teachers to initial for their attendance. Parents/guardians will be required to sign the practice log at the end of each month. The music teacher will collect the practice log at the end of each month.

    PAYMENT PLAN

    Music lessons are not limited due to financial restraints. Payment plans will be unique to each family and will be discussed during enrollment with supervisors. Payments should be made in monthly installments to the administrator only. Delinquent payments must be discussed with the administrator.

    INSTRUMENT RENTAL/LOAN

    Keyboards and instruments may be available for rent/loan and may be checked out for a term on a first come basis. The parent/responsible person must sign a Rental Agreement. A minimum rental deposit may be required and will be returned if no damage to the instrument occurred.

    SNOW DAYS/INCLEMENT WEATHER

    The Helen L. Fox Gospel Music Center will close when Kalamazoo Public Schools close and/or when the Douglass Community Center closes. The closing will be announced via our text messaging service. Students will not be charged for lessons if the music center closes.

    LESSON CANCELLATION

    The Helen L. Fox Gospel Music Center reserves the right to cancel lessons due to teacher illness or other unforeseen emergencies. The music center will do it’s best to contact students/parents in advance. Students will be given the opportunity to make up the lessons and not be penalized with an unexcused absence.

    Required: Review the Consent to Participate and complete the signature portion at the end.
    You will not be able to submit the form until this is completed.

    Consent to Participate & Waiver of Liability

    Consent to Participate / Conduct

    I/We (Parent/Guardian of Student, and the "Student" requests to be a participant in the Music Education Program offered by the Helen L. Fox Gospel Music Center (HLFGMC). Parent/Guardian and Student understand that Student shall act responsibly and with self-control while participating in the Program. Student and Parent/Guardian acknowledge that Student is a person able to make reasonable decisions about his/her conduct and Student shall accept full responsibility and accountability for such conduct while participating in the Program. Student agrees to abide by the code of conduct, policies and procedures of the HLFGMC as well as the Douglass Community Association building code while participating in, going to and coming from the Program. Misconduct may be subject to discipline including suspension or removal from continued participation in the Program.

    Policies

    Student and Parent/Guardian agree to be subject to the policies of HLFGMC including policies related to attendance, tardiness, at home practice, and other policies as issued. Student and Parent/Guardian understand that each student enrolled into the Program is expected to attend each lesson/rehearsal/recital as scheduled. HLFGMC will make every attempt to advise of schedule changes as soon as possible. Student and Parent/Guardian agree to give advance notice of unavoidable absences. An excessive number of unexcused absences or absences with no advance notice will be grounds for removal from the Program.

    Consent to Photograph/Video/Media Use

    Student and Parent/Guardian grants permission to the HLFGMC to take and use the Student’s image, likeness, audio and video recordings for purposes of HLFGMC media purposes to include but is not limited to its website, social media pages, brochures and/or other marketing materials or submissions for community events, fundraisers, grant applications and the like. We waive any compensation as a result of this activity. I retain the right to withdraw this permission in writing to the HLFGMC however, I understand that any print, media, audio, visual or other materials previously published in reliance on this permission may not be able to be retrieved.

    Waiver of Liability Claims/Hold Harmless

    As a condition of Student’s participation in the Program, Student and Parent/Guardian agree to indemnify, hold harmless and waive all claims or suits for damages or injury arising from the Student participating in the Program and liability against the Helen L. Fox Gospel Music Center, its officers, agents, employees, contractors, and volunteers, personally, individually, jointly or severally liable for injury, accident, illness during or by reason of this Program participation. Parent/Guardian waive any and all rights to hold the HLFGMC for any and all claims.

    Payment Terms

    Payment terms and conditions will be negotiated subject to the policies and procedures of the HLFGMC, which may be amended, from time to time with the giving of notice to Student and Parent/Guardian.

    Signature & Acceptance

    By typing your name and submitting this form you verify and agree that it will be legally binding and enforceable and the legal equivalent of your handwritten signature, pursuant to the Uniform Electronic Transmissions Act, PA 305 of 2000, MCL 450.831 et. seq.

    Signature: Type your name:*