Orangeville Christian School of MusicOrangeville Christian School is a private, independent Christian School serving Shelburne, Caledon, Grand Valley and Orangeville as well as rural Dufferin County. Start Process School of Music Registration Form 2021-2022 PLEASE COMPLETE THE REGISTRATION FORM BELOW: SOM Financial Form 2021-22 Updates Please enter student's name:Student's Grade: (as of September 2021)- Select Grade -Junior KindergartenSenior KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Student’s Date of Birth:Please enter your name:Please enter your home phone number:What is your email address?Please enter your work phone number:What is your Lesson Type (instrument):Choose instrument(s):BassBass ClarinetClarinetDrumsFluteGuitarPianoRCMRecorderSaxophoneTheoryUkuleleVoicePlease enter your cell phone number:Please select your child's current teacher:LAURA MOYER (JK)EMILY TALSMA (Gr. 1)MEREDITH DYKSTRA (Gr. 1 / Gr. 2)JULIE SCRIVENS (Gr. 3)KRISTIN TRAFFORD (Gr. 4)JENNY BAKKER (Gr. 5)ALICE BLYDORP (Gr. 6)KRISTIE WALRAVEN (Gr. 6)MANS EISEN (Gr. 7 / Gr. 8)Student’s Music Background:Lesson Day (indicate preferences):No PreferenceMondayTuesdayWednesdayThursdayFridayLesson time to be determined.Music Teacher Requested:- Please select music teacher -Chris PrinsLeah AshbyRyan GristCost per lesson for each instructor:The cost per 30 minute lesson for is: $28.00The cost per 30 minute lesson for is: $28.00The cost per 30 minute lesson for is: $28.00List of Classes that student would prefer not to miss:Additional Notes:Payments will be deduced monthly on the 15th from parents accounts as per OCS monthly incidental costs. Payments will be evenly paid over 9 months. (Oct 15 to June 15). Invoice will come from bookkeeper just after month ends. Please see PAP Terms and Conditions below.PAP Terms and Conditions1. I/We warrant that the provided information is accurate. 2. I/We will inform that payee, in writing, of any change in the information provided in this section of the authorization 10 calendar days prior to the next due date of the Pre-Authorized Payment (the "PAP") 3. I/We acknowledge that the authorization is provided for the benefit of the Payee and the Processing Institution and is provided in consideration of the Processing Institution agreeing to process debits against my/our account as listed above, (the "Account") in accordance with the Rules of the Canadian Payments Association. 4. I/We warrant and guarantee that all persons whose signatures are required to authorize withdrawals from the account have signed the authorization on the reverse side of this page. 5. I/We hereby authorize the Payee to issue Pre-Authorized Payments drawn on the Account for the following purposes: tuition, donations, share program, lunch program (pizza), options, pie purchases, meat purchases, golf tournament purchases, school of music and any other payments payable to “Orangeville Christian School" 6. I/We will ensure funds are available for withdrawal on the due date. 7. I/We consent to having the School collect personal information that may include names, addresses, telephone numbers, name of financial institution, bank account numbers and any similar information required for processing payments. I/We further consent to the use and disclosure of information contained in this form and otherwise collected by or on behalf of the School for the purpose of processing payments to the School. 8. I/We may cancel the Authorization at any time upon providing written notice of 30 days to the payee. I/We may obtain further information at my financial institution. 9. I/We may dispute a PAP only under the following conditions: - The PAP was not drawn in accordance with the Authorization. I/We have certain recourse rights if any debits do not comply with this agreement and have the right to reimbursement for any debit that is not authorized and is not consistent with this PAP agreement. I/We have certain recourse rights and can obtain more information on my recourse rights by contacting my financial institution. - The Authorization was revoked. In order to be reimbursed for a PAP in dispute, written notification must be received within one month of the posting of such PAP. I/We have certain recourse rights and can obtain more information on my recourse rights by contacting my financial institution. The undersigned agrees to the financial arrangement as stated in the Policies and procedures and has read and agreed to the PAP Terms and Conditions.* Please download and read the Policies and Procedures booklet to access extremely valuable information regarding our music lessons.Please sign here: Sign Here Submit Form