Middle School Ensemble Registration

Who: Children entering 6th, 7th & 8th grade in the fall of 2023.

When: Rehearsals are on Wednesdays from 5:00-6:30 pm. The first rehearsal will be September 6th.

Where: Leopard Rehearsal Space ~ 969 South 2nd Street, 40203 ~ Corner of 2nd & Kentucky

Cost: Tuition is $50/month + a $15 performance shirt that will be purchased later in the year. Tuition is paid in two payments: $200 is due here with this registration (for Sept-Dec). You will be invoiced by email for a second tuition payment in January for the second half of the year.

What: Middle School Ensemble is an expansion group of the Louisville Leopard Percussionists. MSE is its own ensemble, not a feeder group into our performance groups. We had so many kids interested in the Leopard experience, we created MSE to allow the older kids to participate in our program. MSE culminates with a performance at the LLP’s BiG GiG each spring. This year's BiG GiG performance will be at The Brown Theatre on Sunday, April 21st, 2024.

How: To register, please complete the following form and make your first tuition payment by credit card. If making this payment is an issue, please contact our Business Manager, Caroline Taylor, at caroline.h.taylor@gmail.com BEFORE COMPLETING THIS FORM. Once you have submitted your registration, you will receive an email confirmation. If you do not receive a confirmation email, your child was not registered. Contact Caroline Taylor with questions.

Student Name*
First Last
Preferred Name (if different than above)
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
- Other
Child's School*
Birthday*
Gender*
Preferred Pronouns (optional)
Race Demopraphic*
This is anonymous data for grant reporting.
- American Indian or Alaskan Native
- Asian
- Black or African American
- Native Hawaiian or other Pacific Islander
- White
- Other
Is your child of Hispanic, Latina/o/x or Spanish origin?
This is anonymous data for grant reporting.
Address*
Street Address Address Line 2 City State ZIP Code
Parent/Guardian Name*
This name must match the name for the credit card being used below.
First Last
Parent/Guardian Email*
This is where your registration confirmation will be sent.
Enter Email Confirm Email
Parent/Guardian Cell Phone*
2nd Parent/Guardian Name
First Last
2nd Parent/Guardian Email
2nd Parent/Guardian Cell Phone
Emergency Contact (Other than Parent/Guardian listed above)*
First Last Relationship Cell Phone
Comments, Questions or Special Requests:
Photo & Liability Release*
I hereby give permission for the above-named student to attend The Louisville Leopard Percussionists (LLP) camps or classes. In consideration of the advantages of LLP, I agree that the Board of Directors of LLP, its agents, and employees shall be exempt from liability for damages, for bodily injury or property damage that might occur while participating in LLP, except to the extent of insurance liability as provided by law. I understand that photos and videos are taken for publicity and distribution purposes. I hereby give my consent for any pictures in which my child appears to be used for purposes related to the promotion of LLP. I release LLP and all its members from any obligation or liability arising from use of such pictures.
I agree to this LLP photo and liability release.
Pediatrician & Medical Insurance Information
Pediatrician's Name Pediatrician's Phone Insurance Co. Policy Number Member Number

Should a medical emergency arise, we will contact you immediately. If a hospital is required, we will send all kids to Norton Children's Hospital on Chestnut Street.
Is there anything else LLP should know about your child? (severe allergies, medications, behavioral issues, special needs, etc.)
First Semester Tuition Payment*
This $200 payment covers tuition for September through December. A 2nd tuition payment of $200 will be due in January for the months of January through April. A $7.50 processing fee will be added to your payment.
Price:
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Same as student address above

Street Address Address Line 2 City State ZIP Code
Email
This field is for validation purposes and should be left unchanged.

Pediatrician's Name	Pediatrician's Phone	Insurance Co.	Policy Number	Member Number