Private Piano Study at the Music Clubhouse
The Music Clubhouse offers the highest quality piano instruction to students of all ages. We currently provide a choice between in-person and virtual piano lessons in light of current public health concerns. The Music Clubhouse is committed to the safety of our students and community, and we reserve the right to modify our policies based on state, local, and CDC recommendations.

If you are new to the Clubhouse, we will contact you shortly to discuss which instructor might best suit you. We work carefully with each new student to assign them to the teacher that will be the best fit in terms of personality, scheduling, and tuition needs.

The Music Clubhouse is located at 808 W. 24th Street, Lawrence, KS, 66046.
If you have any questions or concerns, please email info@musicclubhouse.com or call or text 785.393.3183.
Sign in to Google to save your progress. Learn more
Email *
Clear selection
Student Name: *
Preferred Pronouns:
Student Age (if adult, specify so): *
Student Birthdate: *
MM
/
DD
/
YYYY
Grade student is entering in school (if applicable): *
My teacher is: *
Parent or Guardian Name(s) and telephone number (please specify call or text preference): *
Address: *
Parent or guardian(s) email address(es): *
Student telephone number, if appropriate:
Student allergies of which we should be aware:
Photography, video, audio, or other media may be acquired during activities at The Music Clubhouse which could identify students and/or family members while in attendance. These items may be published in print and/or electronic media at the careful discretion of the faculty member and Music Clubhouse director. Do you give consent for us to use media of your child in this way? *
Required
Please check the boxes below: *
Required
I prefer: *
Do you wish to participate in our lesson swap system, which allows you to contact other participating students and arrange to swap lesson times in the event that you have a conflict? Please specify yes or no. If yes, provide the phone and/or email information you would like us to publish on the list: *
How did you hear about The Music Clubhouse? (optional)
Anything else you'd like us to know?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy