Ensemble Registration Suzuki School ☰ Menu About Us General Information Admissions Faculty & Staff Directory Orchestra, Ensembles & Chamber Music Calendars & Events New Students Alumni All applicants are welcome to disclose their personal pronoun preferences, though no one shall be compelled to do so. An applicant may register one time for multiple ensembles, for example Summer Workshop and NIYO. UNI Suzuki School Ensemble Registration Ensemble preference (you may choose more than one) Northern Iowa Youth Orchestra (grades 9 – 12) Fridays Northern Iowa Junior Orchestra (grades 5 – 8) Fridays Strings Only Verismo Chamber Ensembles (grades 2 – 12) see scheduling preferences below Summer Orchestra-dates August 12 - 19, 2024 Student Last Name Student First Name Preferred Pronouns (Optional) - None -he/himshe/herthey/them Grade in School for fall 2024 Student Birthdate (required for ages 18 and under) Instrument Parent or Guardian Email Additional Email All correspondence will be sent to the above email addresses. I give permission to share this email with other ensemble members. - None -YesNo Phone #1 - None -HomeParent cellStudent cell Phone #2 - None -HomeParent cellStudent cell Mailing Address Street City Zip Person responsible for payment Payee’s email address Relation 1 - None -MotherFatherOther Parent or guardian name (adult applicants can put NA) - None -MotherFatherOther Private lessons - None - I am currently taking lessonsI am not currently taking lessons Private lessons set Teacher name Teacher Emai Teacher Phone Comment School (put NA for adult applicants) Orchestra or Band Teacher (put NA if this does not apply) Current piece Title Composer Book Ensemble experience: Check as many as applicable. Northern Iowa Junior Orchestra Northern Iowa Youth Orchestra Verismo Honors or All-State Church or school small ensemble School orchestra or band Other… Enter other… Required ONLY for Verismo ensemble scheduling My child is currently in a Verismo ensemble. - None -YesNo Ensemble preference - None -Stay with current ensembleReassign to another ensembleFirst time member Scheduling options Please indicate student’s availability for Verismo ensemble scheduling. Select as many options as possible. Monday 4:00 5:00 6:00 7:00 Wednesday 3:00 4:00 5:00 6:00 7:00 Thursday 4:00 5:00 7:00 Friday 4:00 7:00 Financial Obligation *I understand that my financial obligation to the UNI Suzuki School for participation in orchestra (NIJO, NIYO or CFCO) is for the activity term (September – December OR January -- April/May OR June – August). Should participation be discontinued mid-term, I agree to pay all fees in full. I understand that if I default on payments, participation privileges will be discontinued and my bad debt will be sent on to a collection agency for recovering fees due.I understand that my financial obligation to the UNI Suzuki School for participation in Verismo is for the full two terms (September - May). Should participation be discontinued mid-term, I agree to pay all fees in full. I understand that if I default on payments, participation privileges will be discontinued and my bad debt will be sent on to a collection agency for recovering fees due.Participation *I understand that participation in all sessions, rehearsals, recitals or concerts and tours, if offered, ensure the optimum success and progress.Photo Release *I understand that the UNI Suzuki School or agents may photograph and/or video/audio record any UNI Suzuki School function which my family may attend. I hereby grant UNI Suzuki School my permission to use such photos or videos for educational, historical or publicity purposes.Information Release *I understand that my contact information will be shared with the UNI Suzuki Association and other staff members. Parental Permission As parent or legal guardian of registrant, I give permission for he/she/they to attend all selected activities. - Select -YesNo Waiver Attendee agrees to indemnify, defend, and hold harmless University, the Board of Regents/State of Iowa, and the State of Iowa, and their employees and agents, from and against any and all actions or causes of actions, claims, demands, liabilities, loss, damage, injury, cost, or expense of whatever kind or nature, for injuries to or the death of any person or persons, or damage to or loss of property alleged or claimed to have been caused by, or to have arisen out of or in connection with or to the use of University premises or this Agreement. Notwithstanding any of the foregoing, Attendee shall not be obligated to hold harmless, defend, or indemnify University from and against any claim, loss, cost, or liability proximately caused by the sole negligence of University. - Select -YesNo Medical information Activity personnel should be aware of the following medical, pre-existing or emerging developmental or behavioral concerns, or allergy information for the registrant. Emergency contact Name Phone Number COMMENTS regarding potential orchestra rehearsal conflicts, Verismo scheduling or ensemble placement. Leave this field blank
