Afterschool 2023 Spring Semester Registration Form

Si necesita ayuda en español, comuníquese con la oficina 908-469-1211 o envíe un correo electrónico a Stephanie Guenard sguenard@institutodemusic.org

Thank you for choosing the Institute of Music for Children's Afterschool Spring program. Classes are scheduled to begin the week of February 14th. Classes are held one day per week (schedule is listed on next page). For help en espanol, please call the office 908-469-1211.

This registration form takes between 10 and 20 minutes to complete.

To see Overview and Pricing, click here.

To see Class Days/Times, click here.

If you are applying for financial assistance, please have your most recent 1040 tax document and a secondary form of current income confirmation ready to upload. More details on page 4 with the financial assistance application.

Parent/Guardian 1 Information

Parent/Guardian 1 First Name

Parent/Guardian 1 Last Name

Parent/Guardian 1 Email

Mobile Phone

Employer Name

Work Phone

Preferred Mode of Communication

The language I prefer is

Comfort level speaking English

Very ComfortableSomewhat ComfortableNot Comfortable

Lives with student(s)?

Household Address

Street

City

State/Province

Zip/Postal Code

Will another parent or guardian will be involved in the students' class participation?

Parent/Guardian 2 Information

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Email

Mobile Phone

Employer Name

Work Phone

Preferred Mode of Communication

The language I prefer is

Comfort level speaking English

Very ComfortableSomewhat ComfortableNot Comfortable

Lives with student(s)?

Parent/Guardian 2 Address

Street

City

State/Province

Zip/Postal Code

Demographic Information

The Institute of Music receives government funding and is therefore required to collect demographic data from all of our clients. The information gathered in this form is kept confidential and will only be used anonymously for statistical reporting.

Family Structure

Living Arrangements

Primary Caregiver(s)

Caregiver Other Relationship

Source of Income

Annual Household Income

Primary Household Language

Secondary Household Language

How many members are in the household?

Emergency Contact Information

Please provide information for 2 Emergency Contacts for the student(s) you are registering.

PLEASE NOTE: Emergency Contacts should NOT be the student's parent or guardian. These should be contacts other than yourself and any other parent/guardian listed on this form.

Emergency Contact #1 First Name

Emergency Contact #1 Last Name

Emergency Contact #1 Relationship to student

Emergency Contact #1 Phone Number

Emergency Contact #2 First Name

Emergency Contact #2 Last Name

Emergency Contact #2 Relationship to student

Emergency Contact #2 Phone Number

How many students are you registering today?

Afterschool Institute Spring 2023 Pricing Packages

The Afterschool Institute

Spring 2023

12 week Spring program begins the week of February 14th through May 20th.

Classes and private lessons in music, acting, dance and more…

GRADES K-12

Classes & lessons are held 1 day per week

Group Class Times

Classes are 60 minutes long unless otherwise indicated.

Tuesdays 5:30pm & 6:40pm

Wednesdays 5:30pm & 6:40pm

*Thursdays 5:30pm & 7:15pm (75 min classes)

*Additional No Cost Thursday offerings: Teen Talk: 4:45pm, Dinner: 6:45pm, Game Time: 8:30pm

Saturdays 10:30am, 11:45am, 1:00pm

**Not all classes are offered every day or for every grade.

Please see website for details regarding day/time/ages/descriptions.

Private Lessons

Covid Protocols – Prior to start of the semester you will receive a Parent Handbook with Covid Protocols including sign in, masking, and social distancing procedures as well as disclosing Covid exposure, and how we will address a Covid positive case on campus.

Afterschool 22-23 Pricing	Standard – 12 Week	Member – 12 Week
1 Group Class	$285	$160
2 Group Classes	$440	$250
3 Group Classes	$650	$370
4 or more Group Classes	$880	$500
1 Private Lesson	$500	$330
1 Private Lesson & 1 Group Class	$655	$415
1 Private Lesson & 2 Group Classes	$940	$580
2 Private Lessons	$875	$575
1 Group & 2 Private Lessons	$1,160	$735
2 Group & 2 Private Lessons	$1,315	$825
3 Private Lessons	$1,375	$905
Adult Private	$625	$400

*Membership Fee is per family- $30 for 12 weeks

Membership requirements per Family: (Based on Point System)

Attend a one-hour, mandatory Membership Meeting

Volunteer time
Fundraising
Social Media Influencer
Supply Teen Night Dinners

Additional Class Fees: Additional fees are assessed for the following classes.

	12 weeks
Piano	$15
Guitar	$15
Ukelele	$15
Drumline	$10
Violin	$5
Art Workshop	$10
Anime & Cartooning	$10
Painter's Studio	$15
Jewelry Making	$10
Fashion Design	$10
Chef Class	$50

Prerequisites:

All Level II and Level III instrument classes require an assessment before registration is confirmed.

Choose Grade Level to see schedule

Kindergarten Class List

TUESDAY
Art Workshop	5:30 - 6:30 PM
Ballet	5:30 - 6:30 PM
Music Explore	6:40-7:40 PM

WEDNESDAY
Acting	5:30 - 6:30 PM
Movin & Shakin	5:30 - 6:30 PM


SATURDAY
African Dance & Drumming	10:30-11:30 AM
Music Explore	10:30-11:30 AM
Movin & Shakin	11:45-12:45 PM
Karate	1:00-2:00 PM
Singing	1:00-2:00 PM

First Grade Class List

TUESDAY
Art Workshop	5:30 - 6:30 PM
Ballet	5:30 - 6:30 PM
Music Explore	6:40-7:40 PM

WEDNESDAY
Acting	5:30 - 6:30 PM
Movin & Shakin	5:30 - 6:30 PM


SATURDAY
African Dance & Drumming	10:30-11:30 AM
Music Explore	10:30-11:30 AM
Movin & Shakin	11:45-12:45 PM
Karate	1:00-2:00 PM
Singing	1:00-2:00 PM

2nd Grade Class List

TUESDAY
Anime & Cartooning	5:30 - 6:30 PM
Art Workshop	5:30 - 6:30 PM
Ballet	5:30 - 6:30 PM
Tap	5:30 - 6:30 PM
Music Explore	6:40-7:40 PM
Piano I	6:40-7:40 PM

WEDNESDAY
Acting	5:30 - 6:30 PM
Movin & Shakin	5:30 - 6:30 PM


SATURDAY
African Dance & Drumming	10:30-11:30 AM
Music Explore	10:30-11:30 AM
Movin & Shakin	11:45-12:45 PM
Tap	11:45-12:45 PM
Karate	1:00-2:00 PM
Singing	1:00-2:00 PM

3rd Grade Class List

TUESDAY
Anime & Cartooning	5:30 - 6:30 PM
Art Workshop	5:30 - 6:30 PM
Ballet	5:30 - 6:30 PM
Tap	5:30 - 6:30 PM
Music Explore	6:40-7:40 PM
Piano I	6:40-7:40 PM
The Re-Mix	6:40-7:40 PM

WEDNESDAY
Singing	5:30 - 6:30 PM
Violin II	5:30 - 6:30 PM


SATURDAY
Music Explore	10:30-11:30 AM
Singing & Dancing	10:30-11:30 AM
Violin I	10:30-11:30 AM
Jewelry Making	11:45-12:45 PM
Tap	11:45-12:45 PM
Karate	1:00-2:00 PM
Singing	1:00-2:00 PM

4th Grade Class List

WEDNESDAY
Piano II	5:30 - 6:30 PM
Singing	5:30 - 6:30 PM
Violin II	5:30 - 6:30 PM
Dance Studio	6:40-7:40 PM
Fashion Design	6:40-7:40 PM
Guitar I	6:40-7:40 PM

SATURDAY
Comic Book Creation	10:30-11:30 AM
Singing & Dancing	10:30-11:30 AM
Violin I	10:30-11:30 AM
Young Chefs	10:30-11:40 AM
Jewelry Making	11:45-12:45 PM
Karate	11:45-12:45 PM
Tap	11:45-12:45 PM
Acting	1:00-2:00 PM

5th Grade Class List

TUESDAY
Acting	5:30 - 6:30 PM
Digital Music Makers	5:30 - 6:30 PM
Drumline	5:30 - 6:30 PM
Singing	5:30 - 6:30 PM
Hip Hop Dance	6:40-7:40 PM
Pop Star!	6:40-7:40 PM
The Re-Mix	6:40-7:40 PM

WEDNESDAY
Piano II	5:30 - 6:30 PM
Podcast Creation	5:30 - 6:30 PM
Singing	5:30 - 6:30 PM
Violin II	5:30 - 6:30 PM
Dance Studio	6:40-7:40 PM
Fashion Design	6:40-7:40 PM
Guitar I	6:40-7:40 PM

SATURDAY
Comic Book Creation	10:30-11:30 AM
Singing & Dancing	10:30-11:30 AM
Violin I	10:30-11:30 AM
Young Chefs	10:30-11:40 AM
Jewelry Making	11:45-12:45 PM
Karate	11:45-12:45 PM
Tik Tok Creation	11:45-12:45 PM
Acting	1:00-2:00 PM
Girl Power Club	1:00-2:00 PM

6th Grade Class List

TUESDAY
Acting	5:30 - 6:30 PM
Digital Music Makers	5:30 - 6:30 PM
Drumline	5:30 - 6:30 PM
Singing	5:30 - 6:30 PM
Hip Hop Dance	6:40-7:40 PM
Pop Star!	6:40-7:40 PM

WEDNESDAY
Piano II	5:30 - 6:30 PM
Podcast Creation	5:30 - 6:30 PM
Violin II	5:30 - 6:30 PM

Fashion Design	6:40-7:40 PM
Guitar I	6:40-7:40 PM

SATURDAY
Comic Book Creation	10:30-11:30 AM
Violin I	10:30-11:30 AM
Young Chefs	10:30-11:40 AM
Jewelry Making	11:45-12:45 PM
Karate	11:45-12:45 PM
Tik Tok Creation	11:45-12:45 PM
Acting	1:00-2:00 PM
Girl Power Club	1:00-2:00 PM

7th Grade Class List

TUESDAY
Acting	5:30 - 6:30 PM
Digital Music Makers	5:30 - 6:30 PM
Drumline	5:30 - 6:30 PM
Singing	5:30 - 6:30 PM
Hip Hop Dance	6:40-7:40 PM
Pop Star!	6:40-7:40 PM

WEDNESDAY
Piano II	5:30 - 6:30 PM
Podcast Creation	5:30 - 6:30 PM

Fashion Design	6:40-7:40 PM
Guitar I	6:40-7:40 PM

SATURDAY
Comic Book Creation	10:30-11:30 AM
Violin I	10:30-11:30 AM
Young Chefs	10:30-11:40 AM
Karate	11:45-12:45 PM
Tik Tok Creation	11:45-12:45 PM
Acting	1:00-2:00 PM
Girl Power Club	1:00-2:00 PM

8th Grade Class List

TUESDAY
Acting	5:30 - 6:30 PM

WEDNESDAY
Piano II	5:30 - 6:30 PM
Podcast Creation	5:30 - 6:30 PM

THURSDAY
Anime & Cartooning	5:30-6:45 PM
Guitar I	5:30-6:45 PM
Music Production	5:30-6:45 PM
Top Chef	5:30-6:45 PM
Chorus	7:15-8:30 PM
Painter's Studio	7:15-8:30 PM

9th Grade Class List

THURSDAY
Anime & Cartooning	5:30-6:45 PM
Guitar I	5:30-6:45 PM
Music Production	5:30-6:45 PM
Top Chef	5:30-6:45 PM
Chorus	7:15-8:30 PM
Painter's Studio	7:15-8:30 PM

10th Grade Class List

THURSDAY
Anime & Cartooning	5:30-6:45 PM
Guitar I	5:30-6:45 PM
Music Production	5:30-6:45 PM
Top Chef	5:30-6:45 PM
Chorus	7:15-8:30 PM
Painter's Studio	7:15-8:30 PM

11th Grade Class List

THURSDAY
Anime & Cartooning	5:30-6:45 PM
Guitar I	5:30-6:45 PM
Music Production	5:30-6:45 PM
Top Chef	5:30-6:45 PM
Chorus	7:15-8:30 PM
Painter's Studio	7:15-8:30 PM

12th Grade Class List

THURSDAY
Anime & Cartooning	5:30-6:45 PM
Guitar I	5:30-6:45 PM
Music Production	5:30-6:45 PM
Top Chef	5:30-6:45 PM
Chorus	7:15-8:30 PM
Painter's Studio	7:15-8:30 PM

Begin Registration Process

Step 1: Choose your Membership Status for all Students

Would you like to become a member?

Weeks chosen

Membership Fee

*Unfulfilled member responsibilities for returning families may affect being accepted into the current Membership program.*

Which membership meeting would you like to attend?

2/22/23, 5:45PM2/22/23, 6:50PM3/2/23, 5:45PM3/2/23, 6:50PM3/4/23, 10:45AM3/4/23, 12:00PM

Campaign ID for orientation

Student Registration

Step 2: Enter the Student's Information below:

Student First Name

Student Last Name

Student Birthdate MM/DD/YYYY (include slashes)

Gender Identity

Race/Ethnicity

Press Command or Control on your keyboard to select multiple options

If Hispanic/Latino

If Other

Current School Name

Grade Level

Is this a Returning Student?

What year did you first participate at the Institute of Music?

Step 3: Make Semester Selections for this Student:

Package Choice

Would you like to register this student for 12 or 24 weeks?

12 Weeks24 Weeks

Number of group classes selected

Group Classes

Group Class 1

Group Class Selection

Rent an Instrument?

For Instrument students only

Supply/Material Fees for this Class

Group Class 2

Group Class Selection

Rent an Instrument?

For Instrument students only

Supply/Material Fees for this Class

Group Class 3

Group Class Selection

Rent an Instrument?

For Instrument students only

Supply/Material Fees for this Class

Group Class 4

Group Class Selection

Rent an Instrument?

For Instrument students only

Supply/Material Fees for this Class

To enroll in additional classes, please contact Kristin

Private Lessons

All private lessons are 30 minutes long. Accommodating each lesson is based on teacher availability. Not all art forms will be available at all preferred days/times. The more flexibility you have, the better chances that we can accommodate your request. We will be emailing you a questionnaire to complete in regards to your child(ren)'s private lessons.

12 Week Scheduling may be subject to limited availability.

Days/Timeframes Available (Check All that Apply):

Tuesdays 3:30 - 5:00 PM	Tuesdays 5:00 - 6:30 PM
Tuesdays 6:30 - 8:00 PM	Wednesdays 3:30 - 5:00 PM
Wednesdays 5:00 - 6:30 PM	Wednesdays 6:30 - 8:00 PM
Thursdays 3:30 - 5:00 PM	Thursdays 5:00- 6:30 PM
Thursdays 6:30 - 8:00 PM	Saturdays 10:00 -11:30 AM
Saturdays 11:30 - 1:00 PM	Saturdays 1:00 - 2:00 PM

Private Lesson 1

Art Form

Rent an Instrument?

Private Lesson 2

Art Form

Rent an Instrument?

Private Lesson 3

Art Form

Rent an Instrument?

Selection Code

Total Registration Cost for this Student

Total Supply Fee for this Student

Total Amount for this Student's Registration

Registrant Name

Young Chef's/ Top Chef's Consent Form

Students will have the opportunity to use kitchen utensils and equipment during the Institute of Music for Children’s cooking program. Students will learn about appropriate handling of food items and safe operation and use of the kitchen equipment and they will be supervised at all times. Parents should be aware, however, that participation involves using knives and other sharp utensils, and that children will be working with and in close proximity to large kitchen equipment and hot items. Classes may also involve handling of raw food items. Although every precaution is taken to prevent accidents, a certain risk is involved due to the nature of the experience, the age of the student, and the learning environment.

Student Food Allergies

Food Allergy Information

No known Food AllergiesMy child's food allergies include:

Student Name

List Food Allergies Here

Are there any other things that you want us to know about your student, such as learning or social skills challenges?

Consent Information

Media Release

I give my consent to the Institute of Music for Children (IMC) to photograph/videotape my child for educational, promotional or documentation purposes and to use such pictures and/or stories in connection with their work. I do release IMC from any claims of compensation.

Media Release

Health and Safety Release

I hereby authorize the emergency treatment by a qualified and licensed medical doctor selected by The Institute of Music for Children in the event of a medical emergency which, in the opinion of the attending physician, may endanger my child’s life, cause disfigurement, physical impairment or undue discomfort, if delayed. This authority is granted only after a reasonable effort has been made to reach me. I also guarantee payment of all charges incurred during this medical treatment (physician, hospital, x-ray, lab, drugs, ambulance, etc.) My student(s) has/have permission to engage in all Institute of Music for Children program activities. The student and/or his/her/their parent/guardian agree to abide by the rules and regulations set up by the Institute of Music for Children for health, safety and welfare of the children participating in the program.

Health and Safety Release

Are there any classes that you were looking for that weren't offered?

Payment Information

If you are registering multiple students, your discount will be reflected AFTER your first payment. Discounts are not shown below.

Total Membership Fee

Total Registration Amount

Total Materials/Supply Fees

Total Cost

This confirms that the student(s) named in this form has permission to participate in classes at The Institute of Music and I will be responsible for tuition fees and will make sure my child attends regularly and has transportation.

Billing Email

Select Your Payment Option

Pay in Full Set up Automatic Payments and pay in InstallmentsApply for need-based financial aid

Installment Schedule Details

Total registration cost for all students will be divided into equal payments, depending on length of semester selected . Membership and supply fees are due with Installment 1.

Click here to agree to the payment schedule below

Installment 1: Today
Installment 2: 3/21/23
Installment 3: 4/21/23

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Installment amount/month

Need-Based Financial Aid

Complete the application below to request financial assistance.

PLEASE NOTE: A $30 fee is required for application processing. This amount will applied to your class Membership fee.

It is required you register as a Member to receive Financial Assistance.

Financial Aid is not available for private lessons.

Need-based financial aid will be awarded after all required financial documentation has been submitted. We encourage you to submit ASAP as financial aid resources are limited.

The following documentation is required for the financial assistance application:

Most Recent 1040 Tax Return

Completion of this form here.
AND
One of the following documents:

Current paystub
Letter from Unemployment/Disability
Letter from Employer confirming employment
Documentation to verify household income

If for some reason you are unable to provide this documentation please contact us to discuss your circumstances at fa@instituteofmusic.org or call 908-469-1211.

After we receive your application, and required information listed above, we will be in touch to schedule an appointment.

Thank you

What is the total amount you are comfortable paying for your child(ren)'s classes?

Would an extended payment plan assist you in paying the tuition?

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How will your child benefit from taking classes with the Institute?

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If you would like to pay more than the $30 deposit per child today, enter the additional amount below.

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