Summer 2023 Registration Form

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Please carefully read the Summer 2023-Studio Policy before completing and submitting the Registration Form below. After this form is submitted and processed, an email will be sent with confirmed lesson dates/times, a link to e-sign the Studio Policy, and an invoice link.

Parent/Guardian Name or Adult Student Name: *

Home Address: *

Home Phone Number: *

Cell Phone Number: *

Email (Adult students may type email, then skip down to the "Allergy" question): *

Child #1 Full Name:

Child #1 Date of Birth:

YYYY

Child #1 School Name & Grade Level finished this June:

Child #1 Musical Interests (ex. instruments at home, music they enjoy listening to, previous/current music experience in or out of school):

Child #2 Full Name:

Child #2 Date of Birth:

YYYY

Child #2 School Name & Grade Level finished this June:

Child #2 Musical Interests (ex. instruments at home, music they enjoy listening to, previous/current music experience in or out of school):

Are there any allergies (food or otherwise), special needs, or health/medical conditions the instructor should be aware of? *

Please select the lesson program(s) you're interested in enrolling: *

"Piano Prep" for PreK and Kinders (ages 4-6)

45-Minute Lessons for "Children, Teens, Adults" (ages 7-adult)

60-Minute Lessons for "Children, Teens, Adults" (ages 7-adult)

Required

Please select the package you're interested in enrolling: *

3 Lessons

5 Lessons

Summer "Flex" Lessons will be offered Monday-Thursday from 10am-6pm (subject to availability) beginning on June 26th through August 10th. Please list which dates/times you're interested in for lessons. You'll receive an email to confirm availability of your selected times. *

By checking the box below, you indicate that you have read, understood, and agree to abide by the terms of the Summer 2023-Studio Policy. *

I agree

Required

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