MUSIC PLAY REGISTRATION FORM
Fall 2015
University of South Carolina
School of Music
Children’s Music Development Center
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Registrations are now being accepted by mail or in person on a first-come, first‐served basis.
Fall 2015 Wednesday classes begin on September 9.
Fall 2015 Saturday classes begin on September 12.
Class size is limited. Check the web for class closings.
o https://secure.touchnet.net/C21544_ustores/web/store_main.jsp?STOREID=11
Make your check for $120 payable to USC School of Music-CMDC, and write your child's name and
desired class section on your check.
Print, complete, and return this registration form with your check to USC School of Music, 813
Assembly St., University of South Carolina, Columbia, SC 29208.
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For more information please contact Dr. Valerio at 803-777‐5382 or wvalerio@mozart.sc.edu.
Child's Name (first and last)
Child's Age __________ Sex ____ Date of Birth __ /__ /__
Parent(s)/Guardian(s)
Phone Number(s)
Email
Address
City
, SC Zip
Please indicate by number your first choice and second choice for class day and time.
Wednesday
Wednesday
Saturday
Saturday
Saturday
Section A – 9:30-10:00 a.m.
Section B – 10:30-11:00 a.m.
Section C – 9:30-10:00 a.m.
Section D – 10:30-11:00 a.m
Section E – 11:30-12:00 p.m.
Newborn -23 months
2-3 years
Newborn -23 months.
2-3 years
3-5 years. Recommended for Pre-Twinkle Suzuki Strings
students.
Please read and sign.
I understand that each Music Play class may be video-recorded for the purpose of music development research
by Dr. Valerio and her students. I understand that those recordings may also be used for the purpose of
teacher training sessions at classes, conferences, and seminars worldwide. I also understand that my child’s
identity, and the identity of the caregiver(s) who accompany my child to classes will be protected.
Parent/Guardian Signature
Date
Please circle how you found us.
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