Paying Parent Name *

Name of Parent/Guardian or School Representative responsible for tuition payments

First Name

Last Name

Child Name *

First Name

Last Name

Paying Parent Phone *

Your number will only be used to confirm registration, confirm attendance and give updates about class cancellations

(###)

###

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Which type of music lessons are you interested in? *

Group Lessons

Private Lessons

History of Music Lessons *

Has your child had music lessons before?

Yes

No

Music Class Policies Check *

Did you read the Music Class Policies?

Yes, I did

No, I did not

Do you agree to adhere to the music class policies? *

Did you read the policies and do you agree to be held accountable to the music class policies?

Yes

No

Additional Parent/Guardian Contact Info

You may add an additional party to receive lesson confirmation and homework.

First Name

Last Name

Additional Parent/Guardian Phone

(###)

###

####

Additional Parent/Guardian Contact Info

You may add an additional party to receive lesson confirmation and homework.

First Name

Last Name

Additional Parent/Guardian Phone

(###)

###

####