Sing Your Way Home: New Student Registration Form

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Welcome to the Sing Your Way Home music family. We are thrilled to have the opportunity to serve your family through music lessons or music therapy. Please fill out the following information to receive more information about scheduling times.

Email *

Student First Name *

Student Last Name *

Nickname

Student Birthdate *

YYYY

Parent/Contact First Name *

Parent/Contact Last Name *

Street Address *

City/State/Zip Code *

Contact Phone Number *

Do you agree to receive text messages and/or reminders for appointments? *

Yes

Parent/Contact Email *

Do you agree to receive email reminders for appointments? *

Yes

What service are you interested in? *

Music Therapy (addressing non-music goals with music strategies)

Piano Lessons

Guitar Lessons

Flute Lessons

Ukulele Lessons

Adapted Lessons (for students with special needs that need modified teaching strategies in order to learn to play instruments)

Other:

Required

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