1. education
2. school
3. private school

Cello Workshops: Beginning & Intermediate Levels
at Xavier University
Monday, August 3 through Saturday, August 8, 2015
For full Workshop information goto: www.CincinnatiYoungArtists.org
Early registration Deadline: June 1, 2015
Please check: ___ Little Artists: (Suzuki Students only) Ages 4 - 10, Books 1 -2
Monday - Saturday, 8/3 - 8/8, 9AM - 12:00PM with option to stay through lunch
and observe master classes and performances until 2PM ; $210/$225 after 6/1
___
Young Artists: (Traditional and Suzuki Students) Ages 7 - 15, Books 3 - 6
Monday - Saturday, 8/3 - 8/8, 9AM - 4PM; $335/$350 after June 1
LEVEL DESCRIPTIONS and REQUIREMENTS:
Little Artists Registration Requirements (Beginning Level) SUZUKI METHOD STUDENTS ONLY:
•Workshop limited to 12 students, Ages 4 - 10
•Study and memorization of at least French Folk Song from Suzuki Book 1 up through Book 3.
•Currently taking private lessons
•Parents/guardians welcome & encouraged to observe. Under 9 must be accompanied with adult.
Young Artists Registration Requirements (Intermediate Level) Suzuki and Traditional Method students welcome:
•Workshop limited to 16 students total, Ages 7 - 15
•Classes are organized by level and age
•Currently taking private lessons
•Suzuki Students: Studying pieces in Suzuki Book 3 through Book 6
•Traditional Students: study of forward and backward extensions, familiar with shifting to 2nd-4th positions, able to play at least 5
different 2 octave scales
•Parents/guardians welcome & encouraged to observe. Under 9 must be accompanied with adult.
If you have any questions regarding which Workshop is appropriate please email [email protected]
Part I: Registration Information
Name: _________________________________________Nickname:____________________________
First
Middle
Last
Address:_____________________________________________________________________________
Number & Street
Apt. Number
____________________________________________________________________________________
City
State
Birthdate:____/_____/_____
Zip
Gender: ___M ___F UpcomingGradeLevel:_____________________
Home Phone: (____) _________________
Cell Phone: (____) ____________________________
Email Address:________________________________________________________________________
Emergency Contact: ___________________________________________________________________
Name
Phone
Page 1 of 3
Part II: Parent/Guardian Information
Name(s):__________________________________________________________________________
First
Last
Address (if different): __________________________________________________________________
Home Phone:_______________________Cell/Work Phone:____________________________________
EmailAddress:________________________________________________________________________
Part III: Musical Profile
Years Studied: ________ Private instructor name:____________________________________________
Private Instructor email:_________________________________________________________________
Piece you are currently working on (Name/Suzuki Book):_______________________________________
Are you currently enrolled in your school orchestra program?
____yes
____no
Name of school:_______________________________________________________________________
Name of school orchestra director: ________________________________________________________
Please list additional music programs you are involved with (i.e. youth orchestras, ensembles, etc.) as
well as other summer music programs you have participated in:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Part IV: Tuition
Enclosed is my (please check one):
___ $210 or Little Artists Workshop, $225 for registrations postmarked after June 1
___ $335 for Young Artists Workshop, $350 for registrations postmarked after June 1
Please make checks payable to: Cincinnati Young Artists
To pay by Paypal make it to: [email protected]
Part VI: Applicant and Parent/Guardian (if under 18) Release
I have read and understand the workshop registration process and financial obligations. I take full
financial and legal responsibility for the registrant. I understand that by registering my tuition is nonrefundable and cannot be prorated unless the Workshop is cancelled.
Signed: _________________________________________________________________
Applicant/ Parent/guardian signature
Date
Please circle your free T-SHIRT SIZE:(youth sizing) S(6-8) M(10-12)
(adult sizing) XS
S
M
L
XL
Additional T-SHIRTS may be ordered for $10 each. Indicate number & sizes _________________
Please send in all completed parts (4 pages total) and payment to:
Cincinnati Young Artists
c/o Sarah Kim, Director
3969 Rose Hill Ave
Cincinnati, OH 45229
Page 2 of 3
Waiver and Release of All Claims
IMPORTANT – PLEASE READ!
In registering yourself and/or your minor child(ren)/ward(s) for participation in the programs of the Cincinnati Young Artists
(hereafter referred to as CYA) at Xavier University (XU), you acknowledge you will be waiving and releasing all claims for injuries
you or your child(ren)/ward(s) might sustain arising out of these programs. To wit:
I recognize and acknowledge that there are certain risks of physical injury to participate in programs of the CYA, and I agree to assume the
full risk of any such injuries, damages, or loss regardless of severity which I or my child(ren)/ward(s) may sustain as a result of participating
in any activities connected or associated with any such programs. I waive and relinquish all claims I or my child(ren)/ward(s) may have
against the CYA, XU and its and its officers, agents, servants and employees as a result of participating in any of these programs. I hereby
fully release and discharge the CYA, XU and its officers, agents, servants and employees from any and all claims from injuries, damage, or
loss which I or my child(ren)/ward(s) may have or which may accrue to me or my child(ren)/ward(s) on account of my participation or the
participation of my child(ren)/ward(s) in any of these programs. I further agree to indemnify and hold harmless and defend the CYA, XU and
its officers, agents, servants, and employees from any and all claims resulting from injuries, damages, and losses sustained by me or by my
child(ren)/ward(s), and arising out of, connected with, or in any way associated with the activities of any of the programs.
Photographs and videos of students engaged in instruction, rehearsal or performance activities may be used in the CYA's publications,
local newspapers, magazines, and related publicity materials. Completion of registration materials and your signature in the space provided
constitutes consent and permission by the student and students’ parent(s) and/or guardians to use the student’s name and/or image for any
advertising, publicity, marketing and packaging. This release is irrevocable.
In the event of an emergency, I authorize the officers of the CYA to obtain emergency medical treatment for my child(ren)/ ward(s).
I HAVE READ AND FULLY UNDERSTAND THE ABOVE
PROGRAM DETAILS AND WAIVER, AND RELEASE ALL CLAIMS.
I SO SIGNIFY BY AFFIXING MY SIGNATURE TO THIS FORM.
Names of Participants:__________________________________
Signed: Parent/Guardian:_______________________________Date:_______________
VIDEO, AUDIO, PHOTOGRAPHY RELEASE
For good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, I [print name] ___________________________________________, hereby give
__Cincinnati Young Artists_______________ [hereinafter, the “Recorder”] the absolute right and
permission, with respect to the video, audio or photographs (collectively, the “Recordings”) taken of
me or in which I may be included with others to use, re-use, alter, sell, publish, or republish thesame, in whole or in part, separately or in conjunction with other recordings, in any medium and for
any purpose whatsoever, including, but not limited to, illustration, promotion, and advertising.
I hereby release and discharge the Recorder and any and all other parties acting under right, title,
assignment, grant, or license from the Recorder from any and all claims, including
negligence, demands arising out of or in connection with the use of the Recordings, including, but not limited to, any
claims for libel, defamation, invasion of privacy, or breach of publicity or other property rights.
I hererby waive any right or inspection or approval of any of the Recordings. This authorization
& release shall inure to the benefit of the Recorder’s family members, heirs, executors, administrators,
personal representatives, employees, agents, dependents, successors and assigns. This
Release shall be binding without restriction as to time or otherwise upon me and my family members,
heirs, executors, administrators, personal representatives, dependents, successors, and assigns.
I acknowledge that Recorder is not an authorized agent, representative or affiliate of Xavier
University and that Xavier University does not have any control over the Recorder or over
the use of the Recordings.
I have read and fully understand the contents of this Release.
______________________________________________________
Signature of Parent/Guardian
Page 3 of 3
__________
Date