New Student Lesson Registration
Child's First and Last Name (and siblings' if applicable) *
Your answer
Parent 1 or Legal Guardian's First and Last Name *
Your answer
Parent 2 or Legal Guardian's First and Last Name
Your answer
Primary Contact Number *
Your answer
Primary Email Address *
Your answer
Child's/Children's Date of Birth *
Your answer
Lesson Location: please check all you'd like to consider. *
Required
If you selected "Home" above, please list your exact home address, including apartment number if applicable (if you did not, please put N/A here) *
Your answer
Please list ALL the days of the week you're available including EARLIEST and LATEST start times *
Example: Mondays 3-6 PM; Tuesdays 4:30-7 PM; etc.
Your answer
Has your child taken lessons before? *
If you answered yes to the question above, how long have they taken lessons?
Your answer
Anything else you'd like to tell us or like us to consider?
Your answer
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