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Registration Policies & Form: 
 
Classes are currently not being offered.  Please contact us if you are interested. 
 
(Registrations after this date may be charged a late enrollment fee)
If this date has passed, enrollment may still be accepted at an adjusted rate.  Please call or email.
 
 

           Parents are welcome to observe classes, though it is not preferred. 

They will be asked to stay in a designated location to avoid distractions for the class.  Parents may also wait in the atrium. 

 

    Details regarding class rules and other pertinent info will be issued upon pre-registration/registration. 

   

    All information received regarding your child(ren) and contact information will be kept completely private.

No names or photos will be taken/released without prior written parental permission. 

 

 

Instructions:

 

The form may be completed in the following ways:

 

             1. Copy and paste it into a new file on your computer.  

             2. E-mail a request for an MS Word attachment to be emailed to you. 

          

The form may be returned in the following ways:

 

             1. E-mail to info@mimesongs.com

           

           Please fill out one form per child & e-mail to info@mimesongs.com. The form will be emailed back to you with the total due. Please print and sign this form, along with the media release form, and return them before the first day of class.  Be sure to include a check or money order to “mimesongs.”  If you choose to pay electronically online, an e-receipt will be sent to you. If you opt for a payment plan, your first payment will be due and consequent payments will be billed according to the agreement.  Failure to make a payment will result in a late fee and/or the students’ temporary suspension from the class until payment is completed. Please be sure to also sign the media release form and submit it with the registration form.  Registration will not be complete without it.  Find the form here.

 

 

Mimesongs Classes Registration Form

 

Class(es)

 

Student Name

 

Birthday

 

Previous Experience

 

Allergies

 

Parent(s)

 

Address

 

Phone Number

Home:

Cell:

Work:

E-mail

 

Emergency Contact Info

 

Date Conflicts

 

Payment Plan

____Semester 

              (Two 15 week payments)                

_____Monthly (Six 5 week payments)

Family Discount?

No, only 1 child enrolled

Yes, 2 children enrolled

Yes, ___ children enrolled

Total Due

(to be filled out by mimesongs only)

Payment received

(to be filled out by mimesongs only)

 

 

Consent and Release form for Mimesongs Music, Mime, & Drama Classes

 

 

            I (we), the parent(s) or legal guardian(s) of _________________________________________________  permit my (our) child to participate in the class(es) taught by Angie Settlemire or a Mimesongs substitute representative.  I (we) release Angie Settlemire, mimesongs, Crossroads Community Cathedral, and anyone affiliated with these, from any responsibility regarding illness or injury of the child listed above incurred during any class or any activity/performance involved with these classes. 

            I (we) also give authorization to Angie Settlemire and anyone associated in leadership with the class to transport or allow my (our) child to be transported to any health care facility in the area where the injury has occurred.  I (we) also authorize any qualified health care facility personnel to administer treatment as deemed necessary for the health of my (our) child. 

            I (we) acknowledge that I (we) have received and will abide by the information regarding payment, rules, expectations, and other logistics involved in the class.

 

 

Parent or Guardian: ___________________________________________________  Date: ________________

 

 

 

 

Questions?

 

Contact Angie Settlemire

info@mimesongs.com

 (724) 967-2723