Youth Class Registration

Dojo Fall Recruitment 2026 (ClassDojo Story)

Fall 2026 Registration

Monday/Wednesday - AJAM ($130; $70 reduced fee) Tuesday - Appalachian Arts ($70; $30 reduced fee) All (Mon, Tues, Weds) AJAM & Appalachian Arts ($200; $100 reduced fee)

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Parent/Guardian Information

Parent Name*

First Last

Email address*

Phone number*

We will never sell or share your phone number or personal information!

May we text you?*

Yes

We will text you to remind you of dates and deadlines; emergency information regarding inclement weather, and personally regarding your child(ren).

Address*

City*

State*

ZIP*

Choose Reduced Payment Option

Please consider my child(ren) for a full scholarship.

Alleghany Jam Classes Only	$130 for the First Child	Siblings are 20% off
Appalachian Arts Class Only	$70 for the First Child
Alleghany Jam & Appalachian Arts	$200 for the First Child
Reduced Payment Option
Alleghany Jam Classes Only	$70 for the First Child
Appalachian Arts Class Only	$30 for the First Child
Alleghany Jam & Appalachian Arts	$100 for the First Child

I am signing up for*

Monday/Wednesday AJAM Only

Monday, Tuesday, Wednesday - AJAM + Appalachian Arts

Appalachian Arts (Tuesdays) ONLY

Number of Members in Household*

Annual Income*

< $21,150

$21,150 - $31,725

$31,726 - $39,975

$39,976 - $48,225

$48,226 - $56,475

$56,476 - $64,725

$64,726 - $72,975

> $81,225

How many children do you want to register?*

Child One Information

This field is hidden when viewing the form

Child's Name*

First Last

Child's Age*

Child's Birthdate*

MM slash DD slash YYYY

Child's School*

Child's Grade*

Child's First Instrument Choice (returning students get priority)*

Child's Second Instrument Choice (in case they don't get first choice)*

Child's First Activity Choice*

Child's Second Activity Choice*

Has Child been in JAM Before*

Any physical/health issues we should be aware of?*

Child Two Information

This field is hidden when viewing the form

Child's Name*

First Last

Child's Age*

Child's Birthdate*

MM slash DD slash YYYY

Child's School*

Child's Grade*

Child's First Instrument Choice (returning students get priority)*

Child's Second Instrument Choice (in case they don't get first choice)*

Child's First Activity Choice*

Child's Second Activity Choice*

Has Child been in JAM Before*

Any physical/health issues we should be aware of?*

Child Three Information

This field is hidden when viewing the form

Child's Name*

First Last

Child's Age*

Child's Birthdate*

MM slash DD slash YYYY

Child's School*

Child's Grade*

Child's First Instrument Choice (returning students get priority)*

Child's Second Instrument Choice (in case they don't get first choice)*

Child's First Activity Choice*

Child's Second Activity Choice*

Has Child been in JAM Before*

Any physical/health issues we should be aware of?*

Child Four Information

This field is hidden when viewing the form

Child's Name*

First Last

Child's Age*

Child's Birthdate*

MM slash DD slash YYYY

Child's School*

Child's Grade*

Child's First Instrument Choice (returning students get priority)*

Child's Second Instrument Choice (in case they don't get first choice)*

Child's First Activity Choice*

Child's Second Activity Choice*

Has Child been in JAM Before*

Any physical/health issues we should be aware of?*

Child Five Information

This field is hidden when viewing the form

Child's Name*

First Last

Child's Age*

Child's Birthdate*

MM slash DD slash YYYY

Child's School*

Child's Grade*

Child's First Instrument Choice (returning students get priority)*

Child's Second Instrument Choice (in case they don't get first choice)*

Child's First Activity Choice*

Child's Second Activity Choice*

Has Child been in JAM Before*

Any physical/health issues we should be aware of?*

In Case of Emergency

Emergency Contact Name*

First Last

Emergency Contact Relationship*

Emergency Phone Number*

My child may be picked up by/travel with:*

First Last

Other than known parents/guardians

Contact Phone Number*

My child may be picked up by/travel with:

First Last

Other than known parents/guardians

Contact Phone Number

My child may NOT be picked up by:

First Last

Comments (Optional and Confidential):

Photo, Video, & Performance Media Permission

Yes, I give permission to photograph, video record, and/or audio record my child, during program activities and performances. I understand these materials may be used for educational, promotional, and informational purposes, including newsletters, websites, social media, and program materials. I understand no compensation will be provided.

No, I do not give permission. I do not grant permission for my child to be photographed, recorded, or included in media use. I understand that student names will not be published without additional consent.

Alleghany Class Registration Total

Price:

Total

How would you like to pay?*

Check/Cash

Credit Card/PayPal

Payment Method

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Reach Out Directly

If you have questions about the upcoming registration, drop us a message, and we'll get back to you as soon as we can.

Phone

Text or Call 336-572-5266

Email address

info@alleghanyjam.com

Location

Alleghany JAM
P.O. Box 1326
360 N. Main Street
Sparta, NC 28675

Hours

Mon: 10AM-5:30 PM
Tue: 10AM-5:30 PM
Thur: 10AM-3:00 PM
Fri-Sun: Closed

Youth Class Registration

Fall 2026 Registration

Parent/Guardian Information

Child One Information

Child Two Information

Child Three Information

Child Four Information

Child Five Information

In Case of Emergency

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Youth Class Registration

Fall 2026 Registration

Parent/Guardian Information

Child One Information

Child Two Information

Child Three Information

Child Four Information

Child Five Information

In Case of Emergency

Reach Out Directly

Connect With Us:

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