One time registration for new students
Classes are led and designed for kids of all developmental stages by a teacher who is a Board-Certified Music Therapist.
Please complete the form for EACH new student or child
Form must be complete by a Legal Guardian
Please be as thorough as you are able, because we are able to use what you share with us about your child to immediately increase their level of comfort in class. We are also able to be more prepared with adaptations to set your child up for success, and implement them more subtly in a group setting.
You will receive a welcome email with your username and password within approximately 48 hours.
To attend a class before you receive your welcome email, please contact us.
Waiver of Claims and Release of Liability
To the best of my knowledge, all information provided above is accurate, and unless otherwise noted in detail under “Special Information,” my child has no physical, emotional or social conditions which make it dangerous for him/her to participate in music program activities with ALTITUNES Neurologic Music Therapy. If any of the information I have stated on this form about my child changes, it is my responsibility to provide ALTITUNES Neurologic Music Therapy with those changes.
I hereby give my permission for my child to participate in all music related programs provided by ALTITUNES Neurologic Music Therapy, and I hereby release and save harmless Susie Frey and ALTITUNES Neurologic Music Therapy from any and all liability and claims which may arise from me and my child’s participation in music classes, music therapy and/or other events provided by ALTITUNES.
By submitting this form you are indicating that you are the parent/legal guardian of the child named on this form, and that you accept and acknowledge ALTITUNES Neurologic Music Therapy's stated policies and conditions for participation.