Western Academy of Pipe Music

SUMMER SCHOOL June 29 – July 3, 2005

PIPER AND DRUMMER REGISTRATION

Early registration is encouraged

Name______________________________________

Address____________________________________

             _____________________________________

Phone______________________________________

Email______________________________________

Age (if under 19)___  Piper or drummer? ___________

Piper: Boarder (full tuition, room and meals)

                           $575 (USD$475)                  ___________                 

            Day Student (full tuition and lunches)

                           $380 (USD$316)                  ___________

 Drummer: Boarder(full tuition, room and meals)

                            $435 (USD$362)                 ___________

                    Day Student (full tuition and lunches)

                             $285 (USD$237)                ___________

Total enclosed                                               ___________

**please note that the drumming school finishes on July 2**

Please send payment to Western Academy of Pipe Music, with completed form,

to the secretary Cecily Grant

                            4165 Hillbank Road

                            Duncan BC V9L 6M1 Canada

WAIVER

I hereby, for myself, my heirs, executors and assignees waive and release any and all rights and claims I may have for damages against the Western Academy of Pipe Music, its instructors, agents or representatives for any injuries which may be suffered by me during the summer school.

Signature (Parent, if under 19)__________________________