Ady’s Symphony Registration

Name*

First Last

Email*

Phone*

Address*

Street Address City State ZIP Code

Child's Name*

First Last

Is this your child's first time to participate in Ady's Symphony?*

Yes, this is our first time!
No

Which session do you wish to attend?*

Please let us know your child's story and why Ady's Symphony is important to him/her.*

Please submit a picture of your child.

Accepted file types: jpg, gif, png, jpeg, bmp, Max. file size: 25 MB.

By submitting a picture, you are giving Ady's Army to use your story and/or image for marketing purposes.

Please note!

If your child is selected, you are giving Ady's Army permission to use your story to solicit donations for Ady's Symphony.

Filling out the registration form does not guarantee a spot. Due to the high demand, we require a $50 deposit that is 100% refundable as long as the participant shows up for their lessons.

Ady's Symphony Deposit

Credit Card*

Card Details

Cardholder Name

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