Music Therapy (Virtual) – Foothills Creative Beginnings

Music Therapy Program

We are happy to offer online Music Therapy sessions through Foothills Creative Beginnings (FCB)! Each week, families will meet online with FCB’s Music Therapist, Emily Brown, for 30 minutes of interactive music and fun! Goals that support the emotional, physical, cognitive and social well-being of the children will be addressed and communicated throughout the sessions. From singing new and beloved songs to improvising and exploring music/instruments from around the world, these sessions will aim to expose young children to music in a productive and inspiring way. Additionally, music activities will be sent home every week to be practiced and utilized! Come prepared to play, dance, and create!

Music Therapy Application Form

"*" indicates required fields

Parent / Guardian

Parent / Guardian Name*

First Last

Email*

Cell Phone*

Home Phone

Child's Name*

First Last

Child's Age (As of September 2023)*

Daycare or Preschool your child attends:*

Sessions will start the week of October 17, 2023

Please note sessions will be held weekly. Select one preferred class time:

Monday (ONLINE)

Tuesday (ONLINE)

Wednesday (ONLINE)

Thursday (ONLINE)

IN PERSON - 45 MINUTES SESSION

PURPOSE

The purpose of the group music therapy experience is to provide children with an opportunity to develop and express themselves through musical exploration, and interactions with the music therapist and group members. Group goals will be outlined and shared within the first month of sessions. Additionally, weekly music activities will be provided for the participants to complete at home between sessions. The Music Therapy program is designed and facilitated by a certified Music Therapist.

ONLINE CONSENT

Foothills Creative Beginnings LIVE online Music Therapy group sessions will be administered by Zoom Professional. Zoom professional is a paid service through Zoom.us that provides the administrator (meeting host) advanced meeting controls to enable encryption. Encryption provides an extra level of security within a meeting. Each meeting will be password protected and each user will be placed in a waiting room until accepted in by the host. Although the internet provides the appearance of anonymity and privacy in music therapy sessions, privacy is still of concern when utilizing online platforms. Each family is responsible for understanding the potential risks associated when participating in online group sessions. Each participant’s name, face, and environment will be visible during the session to all group members. Although video and microphone use will be encouraged, each family has the right to participate with their video camera or microphone off. Foothills Creative Beginnings is not responsible for the actions of participants in the online music therapy sessions. Sessions will not be recorded or stored in any way through zoom.us. To see the full privacy statement for zoom.us, please visit Privacy | Zoom.

Please check the box next to the activity you give consent for your child to participate in:*

Audio recording that includes, but is not limited to the creation of recordings through recording software (such as Garage band, voice recorder, mix CD’s etc.)

Video recording includes but is not limited to the creation of a music video recorded during a session (for both entertainment and educational purposes to share with parent/guardians).

Photographs for use within the program.

Consent*

By checking this checkbox, and signing the consent form, you are consenting to the participation of your child in the LIVE Online Music Therapy sessions with FCB Music Therapist, Emily Brown (effective October 17th, 2023). You acknowledge that you have read and fully understand the terms, risks, and limitations outlined in this consent form. You agree to communicate with Foothills Creative Beginnings with any questions or concerns that may arise in the program. You understand that you can withdraw your consent at any time through written notice sent to office@foothillscreative.org.

Parent/Guardian Signature*

Date*

CAPTCHA

If you have any questions or concerns please call 403.300.5543

Note: The information disclosed within this application form is used for Foothills Creative Beginnings registration purposes only and will be kept confidential.