LYSO Registration Form

Registration Information

I would like to... *

A $50 non-refundable deposit will hold your spot in the program.

Would you like to be on an installment plan for payments? *

Please note the Community Music School does not store your credit card information, and installments will not be paid automatically.

Are you enrolled in other Community Music School programs for the 2023-24 academic year? *

Student Information

First and Last Name *

Preferred Name

Gender *

Female

Male

Not Available

Birthdate *

Year

Month

Day

Instrument *

Name of School (2023-24 academic year) *

Grade (2023-24 academic year) *

Do you study with a private teacher? *

Private Teacher Name *

Curricular Music Verification

Students registered for Community Music School ensembles are also expected to participate in a curricular (during the school day) performing musical ensemble when available. LYSO should not substitute for curricular music programs.

I verify that this student is enrolled in curricular music program(s).

Curricular music programs are not offered at this student's school/grade level.

Curricular Music Verification *

Please list the teacher and class name for each curricular ensemble the student is enrolled in for the 2023-24 year. *

Parent/Guardian Information

First and Last Name *

Home Address *

City *

State *

Zip Code *

Email Address *

Billing and program information will be sent to this email address.

Verify Email Address *

Phone Number *

Format ex. 9205551212

Home

Cell

Home or cell *

Parent/Guardian 2 Information

First and Last Name

Is the home address the same as the parent/guardian above?

Home Address

City

State

Zip Code

Email Address

Program information will be sent to this email address.

Verify Email Address

Phone Number

Format ex. 9205551212

Home

Cell

Home or Cell

Ensemble T-Shirt

LYSO T-Shirt

All Lawrence Youth String Orchestra students receive a LYSO t-shirt upon registering. Shirts feature the Community Music School logo on the front and the LYSO graphic on the back, the color is TBD. They will be distributed at rehearsal in the fall.

The LYSO t-shirt is royal blue. The front side has the Community Music School logo on the right breast, and the back has the LYSO logo large in the center. The logo consists of a stylized "O" that looks like a string instrument.

Click here to view a size chart.

T-Shirt Size

Parent/Guardian Volunteering

The Community Music School is looking for parent/guardian volunteers to help with events during the year. Please select your preferred options below if you are interested in volunteering.

I would like to volunteer for...

Concert poster distribution

Concerts - taking tickets and handing out programs

Emergency Contact

The emergency contact cannot be the parent/guardian previously listed. In the event of an emergency, the parent/guardian listed above will be contacted first; the name below will be used only if the parent/guardian cannot be reached.

First and Last Name *

Relationship to Student *

Phone Number *

Format ex. 9205551212

Health Information

Please list any allergies, medications, asthma, diabetes, epilepsy, seizures, etc. Please put N/A if there are no concerns *

Does your child have any learning or behavioral needs? *

Yes

If so, please list needs or accommodations: *

Electronic Signature of Parent or Legal Guardian *

Type your name here to sign and confirm the emergency contact and health information.

Community Music School Guidelines

Registration in a Community Music School program indicates understanding and acceptance of our guidelines.

Acknowledgement *

By checking this box, I agree to follow all Community Music School guidelines and accept responsibility for all charges and fees that are incurred.

Assumption of Risk and Release of Liability

This document affects your legal rights - read it carefully.

I am registering for a Program of the Lawrence Community Music School during the program year July 2023-June 2024. I acknowledge that the Program is voluntary and may involve certain risks, including those described below.

I understand that the Program involves, among other activities, rehearsing, performing, engaging in recreation, and, if applicable, traveling off campus. I acknowledge that these activities present certain inherent risks beyond Lawrence University’s control.

I choose to participate in the Program understanding its associated risks, and I knowingly and voluntarily assume all risks of injury, illness, death, or damage to or loss of my property that may occur while rehearsing, performing, traveling, engaging in recreation, or any activities arising out of or related to the Program.

My participation in the Program is voluntary, and I understand that I may discontinue my participation at any time in light of the risks I am assuming.

I hereby forever release Lawrence University, its trustees, officers, employees, and agents (the “Released Parties”), from liability for any negligent act or omission arising from my participation in the Program, including related costs, damages, claims, or assertions to which I or my family, estate, or heirs may claim against the Released Parties.

This Assumption of Risk and Release of Liability shall be construed in accordance with the laws of the State of Wisconsin, which shall be the forum for any lawsuits filed under or incident to this Release or the Program.

Acknowledgement *

By checking this box, I agree to the Assumption of Risk and Release of Liability.

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