Register for Music & Movement Classes

Register for Music & Movement Classes

NWISC Online Registration Form for Music & Movement Classes

Please contact us if you would like a printable mail-in registration form.

Click here for class descriptions. Please contact us for the current calendar.

Name of Student(s):
Nickname / Preferred Name (if different than above name):
Birthdate(s):
Grade(s) (if applicable):
Music & Movement Course:
Name of Parent(s):
Address:
City:
State:
Zip:
Home Phone:
Cell Phone 1
Cell Phone 2:
Work Phone:
E-mail 1:
Email 2:
If someone else will be bringing your child to class, what is his or her name and relationship to your child?
Is your child new to our conservatory or returning?
If you are new to our conservatory, please share how you found out about us, or whom we may thank for referring you.
If your child attends a school or preschool, what is the name of that school?
Sibling(s) (names & birthdates)
Musical background of family (list any instruments you play):
I am sending a check for tuition, made out to NWISC, to: NWISC, 505 Don Hovey Dr., Valparaiso, IN, 46383

By clicking on the "Submit" button, I acknowledge that I have read and understood NWISC's policies and agree to the terms within. I wish to register myself or my child for the course indicated. I understand that photographs taken in class may be used without financial compensation, unless otherwise indicated in writing. Submission of this registration indicates my agreement that I will not hold NWISC responsible for any loss, damages or injury incurred directly or indirectly from participation in any NWISC program or class.

NWISC * 505 Don Hovey Dr. * Valparaiso * IN * 46383