Register | Harmony for Youth

Form 1 of 3

Student Registration

Please complete one form per student. Fields marked * are required.

Student information

Student full name *

Date of birth *

Age

School (optional)

Grade

A little more about your student

Please list any musical instrument or related experience and education.

Does your student have any allergies that program staff should know about?

Any other medical conditions or accommodations we should be aware of?

Are you aware of any learning disabilities that we need to be aware of?

Please state any concerns you might have that Harmony may assist with (e.g. bullying, social / peer pressures, etc.).

Parent / guardian information

Parent / guardian name *

Relationship to student

Phone *

Email *

Home address

As a parent / guardian, would you like to volunteer with Harmony?

Yes, please tell me more Maybe later Not at this time

Additional parent / guardian information (optional)

Parent / guardian name

Relationship to student

Phone

Email

Home address

As a parent / guardian, would you like to volunteer with Harmony?

Yes, please tell me more Maybe later Not at this time

Emergency contact

Name *

Phone *

Relationship to student

Photo / media consent

Harmony for Youth may photograph or record students during programs and events for promotional use (website, social media, newsletters).

I GIVE permission for my child to appear in photos / video. I DO NOT give permission for my child to appear in photos / video.

How did you hear about us?

By checking this box, you read, agreed to and understand our privacy policy, in accordance with The Personal Information Protection and Electronic Documents Act and agree to be contacted by email and/or phone for the purpose of which information has been provided. *

Signature

I confirm the information above is accurate and I consent to my child's participation in Harmony for Youth programs.

Parent / guardian signature (type your full name) *

Typing your name here acts as your electronic signature.

Date signed *

Form 2 of 3

Anti-Bullying Pledge

At Harmony for Youth, everyone deserves to feel safe, welcome, and respected. By signing this pledge, I promise to help make that true.

My promise

I will treat everyone with kindness and respect, in person and online.
I will not bully, tease, or leave others out on purpose.
I will include others and welcome new friends.
I will speak up in a kind way if I see someone being treated unfairly.
I will tell a teacher, volunteer, or trusted adult if I see bullying.
I will help make Harmony for Youth a safe and happy place for everyone.

Form 3 of 3

Pay It Forward Agreement

Harmony for Youth gives kids the chance to learn music and the arts, often free or at low cost, thanks to the kindness of donors, sponsors, and volunteers. "Pay It Forward" means passing that kindness on to someone else.

My Pay It Forward promise

Because someone took the time to teach me, I promise to "pay it forward" by doing something kind for others. I will:

For every hour I receive in Harmony I will give back 1 hour of community service.
Use what I learn to bring joy to others (for example, performing, helping, or sharing).
Encourage and support other students at Harmony for Youth.
Remember that a small act of kindness can make a big difference.

Questions about registration? Email admin@harmonyforyouth.ca or use the contact form.

Register & forms

Student Registration

Anti-Bullying Pledge

Pay It Forward Agreement