Registration

Registration Form

Student Name

Address

City

State

Zip Code

Date of Birth

Gender

Male

Female

Student Class

New Kid Student

New Adult Student

Returning Kid Student

Returning Adult Student

Guardian Name

Cell Number

Preferred Contact Method (select all that apply)

Text message

Other:

Panalley Steel Orchestra makes an effort to provide a safe and secure environment for your child during every session. In order to better protect the safety and health of your child, we request that you provide emergency contact information. We request that the parent/guardian provide another contact (not living at the same address) who is authorize to act on his/her behalf should the parent not be available.

EMERGENCY CONTACT

Same as above

Yes

Name

Cell Number

Please list all allergies including food, medicine, seasonal allergies, or latex

CLASS INFORMATION

Location: PANALLEY PAN STUDIO

224 East 51st Street

Brooklyn NY, 11203

First Day of Classes: Thursday July 17th, 2026

New Kids Class Time: Thursday (5:00pm to 6:00pm) Friday (6:00pm to 7:00pm)

Adult Class Time Thursday (6:00pm to 7:00pm)

Class Fee: $25 a class

PHOTO WAIVER

To protect the privacy and safety of Panalley Steel Orchestra program participants, personal information about participants (such as birthdates, email addresses or phone numbers) will not be published on any Panalley Steel Orchestra webpage under any circumstances.

Please not that no permission is required for large group photos in which the students are not individually identified.

DISCLAIMER

I am aware that still photos and videos of my child may be taken on the premises of any Panalley Steel Orchestra program site as well as during off-site sanctioned extra-curricular activity (i.e. recitals, field trips, etc.). I am aware that still photos and video may be posted to the website and/or be used in a variety of collateral printed pieces (i.e. brochures, newsletters, flyers, print ads). The pictures/video will be used for the purpose of illustrating, advertising, and promoting the activities associated with Panalley Steel Orchestra programs.

I have read the disclaimer and agree to allow my child to be photographed.

Yes

REGISTRATION

Start Your Musical Journey

CLASS INFORMATION

PHOTO WAIVER

DISCLAIMER

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