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Beginner Ukulele Course
Date: TBD - January 2020
Email address *
Name of Parent *
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Name of Child *
Your answer
Age of Child *
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Birthday of Child *
MM
/
DD
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YYYY
Name of caretaker bringing child to class (if different from parent)
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Parent Email Address *
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Parent Phone Number *
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Are there any special needs or details about the child that would be helpful for the teacher?
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I understand that I owe a fee of $100, due before classes begin. *
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Which payment form would you like to use? *
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I understand that I will receive a payment request (using my preferred method) via email, and will respond by paying the registration fee in full at my earliest convenience, before the start of the session. *
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