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Private Lesson Registration
I look forward to working with you and/or your family. Please fill out this form to register for your course(s) of choice. Once this form is completed, I will send you an invoice and an introductory email.
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Who is filling out this form?
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Student
Parent/Guardian
Other:
Name of Student
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Your answer
Age of Student
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Your answer
Name of Person Filling out Form
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Same as Above
Other:
Phone Number
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Your answer
Email Address
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Your answer
Preferred Method of Contact
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Phone/Text
Email
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