Grace Notes Piano Studio: 2023/2024 Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please take a moment to read through the 2023/2024 Studio Policy found here: 2023/2024 Studio Policy & Tuition

From time to time, I may want to take a photo or a video of my students to share with my studio social media channels (Facebook and Instagram) or to post on my studio website or YouTube channel. In order for me to do that, I must have parental/guardian consent for students under the age of 18. This form will serve as permission for all students within the same family.

This form also includes space for you to share information with me such as food allergies, learning differences, special circumstances or any other pertinent personal information that you'd like to disclose. All information provided will be kept strictly confidential.

Email *

Parents' name(s): *

Student's name(s): *

Have you read and understand the 2023/2024 Studio Policy? 2023/2024 Studio Policy & Tuition *

Yes

Required

Studio Social Media, YouTube and Website Permission *

YES, my child(ren)'s IMAGE/VIDEO and FIRST NAME may appear online.

YES, my child(ren) may have their IMAGE/VIDEO ONLY (no name) appear online.

YES, my child(ren)'s IMAGE/VIDEO may appear online as long their face isn't showing.

My child(ren) may participate in YouTube VIRTUAL RECITALS ONLY.

NO, I do not wish my child(ren)'s image/video or name to appear online.

Any relevant personal information or special circumstances (if any) regarding your child(ren) that you'd like to share:

Do you have any address or contact information to update? If so, please add it here:

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms