Student Enrollment Form
Session 9

sINgSPIRE is a 10-week individual voice lesson program that combats cystic fibrosis
through the art of singing.

Students are paired with a professional sINgSPIRE voice instructor based upon their age, weekly lesson availability, and instructor availability. Lesson materials, music, and program aides will be provided by Breathe Bravely.
The sINgSPIRE program is reserved for children 12+ years of age, adolescents, and adults with CF.

Video-Call Lessons

An innovative and impactful teaching method for sINgSPIRE. Video lessons take place via a video call platform called ZOOM. Because of this technology, student and the instructor may remain in their respective locations and still take part in the program and lessons! The student must have access to reliable Wi-Fi and a device such as an iPad, tablet, or laptop.
Instructions for connecting via video call will be sent out after enrollment into the sINgSPIRE program.

Take the Next Steps

1. Fill out the application
Spots are limited to five new students a session and they fill up quickly! Make sure to get your application in ASAP!

2. sINgSPIRE Session Placement
Once Breathe Bravely receives the application and it is reviewed, Breathe Bravely will connect with you and welcome you to the sINgSPIRE program, or connect you with your returning instructor!  

3. Instructor Placement & Connecting
You will be paired with an available sINgSPIRE instructor and a studio policy and protocol will be sent via email. From there, the assigned instructor will set up a specific lesson time that works for the student and be in direct communication with the student/guardian. Lessons will be recorded and shared with students for practice purposes and review.

4. Breathe, Sing, Inspire
Now that you're officially a part of sINgSPIRE, you've connected with your instructor, and you've set up your lesson times - just enjoy the art of singing and all that it can do for you and your journey living with CF.

sINgSPIRE Enrollment Application
Student Name *
Student Name
Returning sINgSPIRE Student *
Returning students, would you like to continue with your same instructor if possible?
Mailing Address *
Mailing Address
Phone *
sINgSPIRE Lessons
**** Lessons (30 minutes)
*Video-Call Lessons require a reliable Wifi connection & Video device.
Please give a general time frame so we may match you with an available sINgSPIRE instructor. (example: Monday 4:30 – 6:30 p.m. / Tuesday 7:00 - 8:00 p.m / Saturday mornings)
Preferred means of communication: *
Previous Music Experience
Have you taken private music lessons before? *
Example: Piano - 3yrs
(general music, choir, band, theater, etc.)
Parent/ Guardian Information (if under 18)
Parent/ Guardian Phone
Parent/ Guardian Phone
Health & Emergency Contact
(cystic fibrosis, diabetes, asthma, anxiety, allergies etc.)
Emergency Contact *
Emergency Contact
Emergency Phone *
Emergency Phone
By typing your name in the box below you acknowledge that you are enrolling yourself or your child in sINgSPIRE - a program by Breathe Bravely specifically for people with cystic fibrosis and that all the information given is accurate.

Enrollment will be awarded upon receipt, review, and approval of this application.

Acceptance into the sINgSPIRE program is based upon the applicant meeting enrollment requirements and is at the discretion of the enrollment committee. If current enrollment is filled, interested students will be placed in order they are received on a waiting list for the next available opening and session.