Music for People with Disabilities

Thank you for your interest in our Music for People with Disabilities program! Please fill out the form below to register for the upcoming session.

Class Selection
Class Time
Have you registered for other Community Music School programs in the 2023-24 academic year?
Student Information
Gender
Is this student 18 or older
Will you be using IRIS to pay for this session?
Parent/Guardian Information
Location
Preferred Phone Type
Parent/Guardian 2 Information (optional)
Preferred Phone Type
Is the home address the same as the parent/guardian above?
Location
Emergency Contact
The emergency contact cannot be the parent/guardian previously listed. The parent/guardian will be contacted first in the event of an emergency. This contact is in case they cannot be reached.
Health Information
Does your child have any learning or behavioral needs?
Type your name here to sign and confirm the emergency contact and health information.
Community Guidelines

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


Acknowledgement
Assumption of Risk and Release of Liability

This document affects your legal rights - read it carefully.


I am registering for a Summer Program of the Lawrence Community Music School during the program year (June 2024 - August 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.
 

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