El Sistema Aeolian New Application

Application Date*

Applicant Child's Name*

First Last

Date of Birth*

Number of siblings in ESA*

Name(s) of Siblings*

School Attending (2023-2024 School Year)*

Grade (As of application date)*

Languages Spoken at Home*

Name of Individual Completing the Application

First Last

Relationship to Child*

Address*

Street Address Address Line 2 City Province Postal Code

Phone

Mobile or Alternate Phone

Email*

Please contact me during ESA hours by:*

Name of Secondary/Alternate Contact*

First Last

Relationship to Child*

Address*

Street Address Address Line 2 City Province Postal Code

Phone

Mobile or Alternate Phone

Email*

Name of Individual Permitted to Pick-up Child*

First Last

Best Method of Contact During ESA Hours:*

Please list any medical condition/special needs/allergies of which we should be aware.*

Name of Individual Permitted to Pick-up Child

First Last

Phone

Name of Individual Permitted to Pick-up Child

First Last

Phone

In the case of a non-emergency medical issue affecting a participant child we will make every effort to contact the parent/guardian. In the case of a medical emergency the program will seek immediate professional care.*

I understand.

Should a child have a serious condition that requires use of a puffer or epipen to stop the child having a major health issue, the program will require that you supply us with a device that we will store on site for any such emergency as well as training to Program Coordinators by the parent in the use of the device to allow them to assist the child if necessary.*

I understand.

I give permission for my child's picture/video to be taken and used to promote the program.*

I give permission for my child's name to be printed in programs and promotional material.*

I give permission for my child participate in meals and snacks while attending the program*

I give permission for the free exhange of information between my child's school and El Sistema Aeolian.*

I give permission for El Sistema Aeolian Staff & Volunteers to transport my child to authorized off-site events as necessary.*

I give permission for El Sistema Aeolian program to correspond with me via emails and newsletters on matters related to the program.*

To belong to this program, participant children and youth are expected to fulfill the time commitment that participation in El Sistema Aeolian represents.*

I understand.

To belong to this program, participant children and youth are expected to bring a positive attitude toward the program and the other participants and abide by the ESA participants Code of Conduct.*

I understand.

Absences for reasons other than illness/emergency will be reviewed on a case-by-case basis to consider the participant’s degree of commitment. In the case of your child needing to miss a session you agree to notify the El Sistema Aeolian office with at least 24hrs notice: elsistema@aeolianhall.ca or (519) 679-2220. When a participant does not fulfil the time commitment, their spot may be offered to an applicant on the waiting list.*

I understand.

How did you learn about the El Sistema Aeolian Program?*

Do you are anyone in your family play a musical instrument, sing, have any musical training? Please specify.*

Please list all after school activities your child is involved with during the school year, including sports and private lessons. Please specify days and times.*

The El Sistema Aeolian program is designed to develop leadership skills, cooperation, and teamwork. Why do you think that this program is a good fit for your child? What are your goals concerning having your child participate in this program?*

This is an intensive program that requires a significant time commitment and for participants to fully engage in the program’s activities. Will you be able to commit the time for your child to attend the program the required number of days per week as well as performances?*

The El Sistema Aeolian’s music instruments are available for loan, free of charge for ESA participants, by signing an instrument loan contract. After a few months in the program, we allow instruments to be taken home. These are expensive and require good care. Do you feel comfortable sharing your child’s responsibility of an instrument for his/her personal practice?*

Part of teaching a musical instrument involves some physical contact with the student. Guiding hands, arms and general posture is often required. Are you comfortable with this? Do you feel your child would be comfortable with this?*

Is there anything else you would like to tell us about your child/yourself?*

Children enrolled in this program participate both in group rehearsals and private lessons. Is there anything in terms of past events or personality traits that teachers should know about and take into consideration when interacting with your child?*

El Sistema relies on community support to achieve its objectives. Please check the areas you would be willing to help with:

Select All
Building maintenance
Gardening
Wardrobe
Classroom Support
Food Preparation
Fundraising
Field Trips/transportation

I and the applicant child understand the time commitment that belonging to this program represents and to fully engage in all the program’s classes and activities, including performances outside of program’s regular schedule (up to 5 days per week).*

We understand.

I and the applicant child understand my/our responsibility for signing in and out my child in a timely fashion, as well as notifying El Sistema Aeolian office about any issues that can cause my child to miss a session.*

We understand.

I and the applicant child understand that El Sistema Aeolian is entirely run by The Aeolian and that a place in the program is equivalent to a $3500 scholarship, which covers the cost of instruction, instruments, classroom and studio space, meals, and other program activities at no cost to the child’s family.*

We understand.

I and the applicant child understand my/our responsibly to care for all property of the El Sistema Aeolian program including any instrument(s) loaned to me/us by El Sistema Aeolian. I/We agree to be responsible for any unreasonable damage to the instrument or property caused by negligence, carelessness, or inappropriate use.*

We understand.

I and the applicant child understandunderstand that El Sistema Aeolian is both a musical program and a social program, focusing on helping children and youth to achieve their full potential and be their very best. The program is designed to develop leadership skills, cooperation, and teamwork. A positive attitude toward the program and its participants is expected at all times.*

We understand.

The above information is accurate at the time of application.*

I agree.

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