Irene's Music Studio Enrollment Form

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We are so excited you are enrolling! Please find my policy on my website, irenestephenson.com/policies Please fill out all fields, including times to call you regarding payment for your classes. You will be filling out a sign off sheet for the policy and payment form before your first lesson.

I understand that enrollment at Irene's Music Studio means I and my student are in 100% agreement of the Studio Policy and its terms (Initial Required Below) *

Please select your preferred, most prompt method of contact. *

Phone

Text

Student First Name *

Student Last Name *

Student DOB *

YYYY

Parent First Name (Leave blank if NA)

Parent Last Name (Leave blank if NA)

Parent Phone *

Parent Email *

Address *

City *

Province *

Postal Code *

Secondary Contact Name (Please enter in case of an emergency, even if an adult student.) *

Relationship to Student *

Secondary Contact Phone *

Secondary Contact Email *

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