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Gaia S.H. Music Studio Registration
Thank you for your continued interest in taking lessons! Please respond to the following questions to register your information. Your responses will not be shared with outside parties. -Gaia
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* Indicates required question
Student's name
*
Your answer
Parent's name (if student is under 18)
Your answer
Parent's phone number (please include area code)
Your answer
Student's phone number
Your answer
Contact email
*
Your answer
Date of birth (if over 18, only provide month and day)
*
Your answer
Grade in school (or graduated)
*
Your answer
Home address (for music and reed shipments)
Your answer
Time zone of student
*
Your answer
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