Youth Orchestra Registration 2017-18 This is a secure order form to be used for credit card payments only. An automated receipt of submission will be sent to the e-mail address indicated on the form. Payments are processed manually. Your credit card information will be stored and processed by our staff. If you have any questions or concerns please contact us or call Christina at 647-988-2102 to take your registration directly. Thank you! Student InformationPlayer Name* First Last Instrument*ViolinViolaCelloBassDate of Birth* Orchestra Tuition OptionsOrchestra [Tuition includes one ticket for each of the 3 youth orchestra performances]*Junior - $325 Full Year Fee. Player level: RCM Gr 2/Suzuki 2-3.Intermediate - $375 Full Year Fee. Player level: RCM Gr 4/Suzuki 4-7.Senior - $400 Full Year Fee. Player level: RCM Gr 8 or higher.PLUS: Discounted Mooredale Concerts Subscriptions $115 for Two Concert Series subscriptions - 6 Sundays 3:15-5:15pm [$230 value] $100 for Four Music and Truffles Series subscriptions - 5 Sundays 1:15-2:15pm [$200 value] Music Teacher InformationMusic Teacher Name First Last Music Teacher Email Parent/Guardian InformationParent/Guardian Name* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Email of Individual Making Payment* Enter Email Confirm Email Contact email for orchestra messages if different from above Enter Email Confirm Email Payment DetailsTotal $ 0.00 CAD Name on Card* First Last Card Number*We accept Visa and Mastercard only.Expiry Date (mm/yy)*Donation to Mooredale Youth Orchestras Total to be charged to your credit card $ 0.00 CAD Consent*Every student registered in the Mooredale Orchestra is thereby also a member of the Rosedale-Moore Park Association. I consent to the participation of the above-named player and hereby release Rosedale-Moore Park Association, its staff, Board of Directors, instructors and authorized guests from any and all actions, claims demands for damages, loss or injury howsoever arising which may hereafter be sustained by the participant as above-named in consequence of participation in Association activities. I also consent to the use by Rosedale-Moore Park Association of the participant’s likeness (photographs, video) for publicity purposes.Agree This iframe contains the logic required to handle Ajax powered Gravity Forms.