| Class size is limited. Registrations will be accepted by mail or in person beginning August 1, 2008 on a first-come-first served basis. (Checks only.) Please make your checks payable to USC School of Music - CMDC and write your child's name on your check. To enroll, print and return this registration form with your check to USC School of Music - CMDC, 813 Assembly, University of South Carolina, Columbia, SC 29208. You For more information please contact the graduate assistants at 777-4065 or email: CMDC@mozart.sc.edu. Your registration will be confirmed e-mail by Friday, August 29, 2008. Child's Name (first and last): _________________________________ Child's Age: _______Sex: ____ Date of Birth: _____/____/_____ Parent(s)/Guardian(s):______________________________________________ Phone Number(s):_________________________________________________ Email:__________________________________________________________ Address:________________________________________________________ City:______________________________,SC Zip:______________________ Please circle your first choice for class day and time. (Assume you will be placed in your first choice unless you hear otherwise.) A B C D E F Please circle your second choice for class day & time. (Because classes fill quickly, this selection should be an acceptable alternative if your first choice is unavailable.) A B C D E F Please Read & Sign - I understand that each class will be video-recorded for the purpose of music development research by Dr. Valerio and her graduate students and for the purpose of teacher training sessions at conferences and seminars worldwide. I also understand that my child’s identity and the identity of the caregiver(s) who accompany my child to class will be protected. Parent Signature:_______________________________Date:___________________ Please circle how you found us! Friend
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