Current BSM Registration

Home
Current BSM Registration
Beginning Piano
Adult Piano
Specialty Camps
BSM Kindergarten Camps
KM Course Descriptions

Summer 2011 at the Burch School

Registration Form – DEADLINE May 11

All current Students at the BSM are required to enroll for a minimum of five private piano lessons, with a maximum of eight lessons. There are also several other camps from which to choose. In order to register print out this page, fill out your choices, and enclose a check for the total amount, payable to The Burch School of Music.

Private Piano Lessons for Non-beginners (minimum of five/maximum of eight)

___________________________________________________________________________________________________________________________________________________________________________

_____ 30-minute lessons	@ $22 times ____ number of lessons	= $ _________
_____ 45-minute lessons	@ $33 times ____ number of lessons	= $ _________
_____ 60-minute lessons	@ $44 times ____ number of lessons	= $ _________
_____ Two to Tango! (duet camp)	@ $40 (four 30-minute sessions: two private/two with duet partner)	= $ _________

Beginner Piano Lessons: Ready, Set, Go! Camp

___________________________________________________________________________________________________________________________________________________________________________

_____ Session I	____ June 13–June 30	9:00 – 10:00 am	(Mon. AND Thurs.)
	____ June 13–June 30	10:15 – 11:15 am	(Mon. AND Thurs.)
	____ June 13–June 30	1:00 – 2:00 pm	(Mon. AND Thurs.)
	____ June 13–June 30	2:15 – 3:15 pm	(Mon. AND Thurs.)
_____ Session II	____ July 11–July 28	9:00 – 10:00 am	(Mon. AND Thurs.)
	____ July 11–July 28	10:15 – 11:15 am	(Mon. AND Thurs.)
	____ July 11–July 28	1:00 – 2:00 pm	(Mon. AND Thurs.)
	____ July 11–July 28	2:15 – 3:15 pm	(Mon. AND Thurs.)

@$110.00 per session (Six 60-minute sessions)

= $ _________

Specialty Music Camps -- for detailed descriptions of the camps, click here

___________________________________________________________________________________________________________________________________________________________________________

_____ Goin’ Country	@ $35.00	= $ _________
_____ I Write the Songs	@ $35.00	= $ _________
_____ Great American Masters I: Great American Fok Songs	@$40.00 (cost includes snacks/crafts)	= $ _________
_____ Great American Masters II: Edward MacDowell	@$40.00 (cost includes snacks/crafts)	= $ _________
_____ Great American Masters III: Aaron Copland	@$40.00 (cost includes snacks)	= $ _________
_____ Great American Masters IV: Alberto Ginastera	@$40.00 (cost includes snacks)	= $ _________

Grand Total Tuition :

$ _________

Emergency Release: My child has my permission to attend camp at the Burch School of Music during the summer of 2011 and to participate in any and all activities, unless specified below, provided by the Burch School. I authorize the Burch School, its employees or its volunteers to call a physician at my expense in case of emergency. I consent to any medical examination, medical treatment, surgery or hospital care under the general or special supervision or upon the advice of a physician or surgeon licensed to practice medicine.

___________________________________________________________ ___________________________
Signature of adult or parent/guardian/managing conservator Date

Physical Activities to avoid: _________________________________________________________________________________________

Emergency name and phone number: ________________________________________________________________________________

Doctor’s name and phone number: ___________________________________________________________________________________

Schedule Request Form

For Non-Beginners and Adult Piano Registration

Name: _______________________________________________________________________

Address: _____________________________________________________________________

_____________________________________________________________________________

E-Mail: ______________________________________________________________________

Home Telephone: _______________________ Cell Telephone: ________________________

Type of keyboard/piano at home: __________________________________________________

Please indicate below the length of lesson requested and which weeks you are available for lessons. To the right of each week is a place for comments, requests, conflicts, etc. (Example: "I am free any time this week except Wednesday after 2:00 pm", or "any day but Friday") PLEASE BE SURE TO LIST ANY AND ALL CONFLICTS. (The more details you can give, the easier it will be to schedule.) Also, please know that spreading out your lessons throughout the summer is more beneficial than having them all in one month. Thanks!

_____ 30 minutes @ $22 _____ 45 minutes @ $33 _____ 60 minutes @ $44

_____ June 1-3 _______________________________________________________________

_____ June 6-10 _______________________________________________________________

_____ June 13-17 ______________________________________________________________

_____ June 20-24 _____________________________________________________________

_____ June 27- July 1 __________________________________________________________

_____ July 5-8 (no classes Mon., July 4) ____________________________________________

_____ July 11-15 ______________________________________________________________

_____ July 18-22 ______________________________________________________________

_____ July 25-29 ______________________________________________________________

Summer Registration and Tuition is due on or before May 11, 2011

Dr. Holly Hughes, Director The Burch School of Music
P.O. Box 2345 Weatherford, Texas 76086

For more information, please call Dr. Hughes at 817-341-2345 (metro)
or send email to HollyHughes@burchschool.com