Registration Form

    *Indicates a Required Field

    Student Info

    Student's Full Name*

    Age*

    If under 18:

    Child's age:

    Parent or Guardian Name(s):

    Note: Minors (under 16) must be supervised at all times by parents or guardians and must leave directly after lessons.

     

    Contact Info

    Phone*

    Main Phone:
     

    Second Phone:
     

    Email*

     

    Address*

    Address Line 1:

    Address Line 2:

    City:

    State:

    Zip Code:

     

    Registration

    Register for Lessons

    This registration is for lessons with:

    Instructor:

    Area of Study:

    Ongoing Academy Registration(s)

    Please list information for any lessons or classes you're currently taking at the Academy:

    Instrument(s):

    Instructor(s):

    Other Family Member(s):

    Additional Info (Optional)

    Student Info

    School Attending:

    Medical or Learning Disabilities:

    Other Interests:

    How did you hear about us?

    Photos

    Would you allow us to use pictures, videos, or recordings on our social media, website, etc.?

     

    Policies

    I have reviewed and understood the policy, and agree to abide by all clauses, rules, and regulations, including the 30 day written notice to terminate lessons clause, with full payment for all lessons covered therein.


    (*Required)

     

    Anti-SPAM Question

    (*Required)

    Please confirm that this is not spam by answering the following question:

     

    Payment

    After you submit this form, you will receive an email with options and instructions for payment. If you do not receive confirmation shortly please check your junk or spam folder.