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Musical Minds Student Registration
MusicalMindsConservatory.com
407.392.3202
Student Name *
Your answer
Student grade and school *
Your answer
Home Address *
Please include a gate code if applicable.
Your answer
DOB (Date of Birth) *
MM
/
DD
/
YYYY
Instrument *
Your answer
Are any siblings/parents in our conservatory? *
Please tell us about your student so we can create an optimal teacher match, personalized curriculum, and positive experience!
This may include learning style, specific goals, personality, disability, disorder, special circumstances, allergies, etc...
Your answer
Parent/Guardian Name(s) *
Your answer
Parent Email *
Your answer
Cell # *
Your answer
Former years of lessons? Former teacher? *
Your answer
How did you hear about us? *
Required
Teacher request
Your answer
Days available for a lesson
Time request
Your answer
Policies and Lesson Contract *
Billing Authorization *
Media Release *
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