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4th and 5th Grade

Strings Club Registration

 

Student Info

Student Name(Required)
Date of Birth(Required)

Student's Music Experience

Parent/Guardian Info

Please enter info for multiple parents/guardians if you'd like:
Parent/Guardian Name(Required)
Email(Required)
Address(Required)
Parent/Guardian Name
Email
Address

Health Information

Please list the student's food, drug, or environmental allergies, if any. Type 'none' if none.
Will the student need to take any medications while at Strings Club Programming, or will the student need to carry any medications with them during Strings Club Programming (such as an epipen for bee stings)? Please explain. Type 'no' if the answer to either question is no.

Insurance

If the student is NOT covered by medical insurance, please type 'none' in all the following prompts.
Max. file size: 10 MB.

Emergency Contact

Please list an adult who was NOT listed as a parent/guardian. This should be someone we can contact in the event of an emergency, in case we cannot get a hold of any parents/guardians listed above.
Name
Address

Authorizations

Parent or guardian, please electronically sign each authorization by typing your full name in each prompt.
I hereby authorize the use of any photos or video taken of my child during Strings Club to be used for advertising purposes in posters, brochures, promotional videos, and social media.
I certify that the health information in my child's registration form is true to the best of my knowledge.
I hereby give my permission to Superior String Alliance to provide routine, nonsurgical medical care, and to secure emergency medical, surgical, and dental treatment for my child in the event of an emergency while she/he/they is/are attending SSA Programming.
I certify that both my child and I, the parent/guardian, have read the SSA Strings Club Handbook (which includes the Student Code of Conduct) found on SSA's website at https://superiorstringalliance.org/strings-club/

Strings Club Tuition Payment

Tuition is due in full by May 17th. If you are applying for a scholarship you will receive an email from SSA within one business day of submitting your registration form letting you know the scholarship amount we are able to give you. We would prefer if you are able to mail a check made out to 'Superior String Alliance' to our address at P.O. Box 52, Marquette, MI 49855. If you need to pay tuition via debit or credit card, please navigate to SSA's donate page and you can pay online via our Paypal donation page. Please send us an email at admin@superiorstringalliance.org letting us know that you paid online and the name of your child.