Piano Prodigies Registration 2018-2019
Required for all students (new and returning)
Student First Name
Please use name that you prefer for printed programs (official name or nickname)
Student Last Name
Student Date of Birth
Please select Month, Day, and Year of Birth
Grade in School this year
Name of School
Make/Model of piano and last tuning date (if acoustic)
First and last names of parent(s)
Parent Email Address
Preferred email address(es) for announcements, reminders, lesson scheduling, etc.
Parent Cell Phone Number
Include street address, city, state & zip code
I have read and agree to the conditions outlined in the Piano Prodigies studio policies.
I hereby authorize Piano Prodigies to use, reproduce, and/or publish photographs and/or video of the above-named student (taken during workshops or recitals) without compensation.
Comments and/or Questions
Send me a copy of my responses.
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