Client Policy Agreement

Parent or primary adult contact

Please provide the following information about the primary adult contact.

First name *

If you use an alternative first name, please include it in parenthesis after your full legal first name.

Last name *

If you use an alternative last name, please include it in parenthesis after your full legal last name.

Email address *

If you have already signed up for a ClassMate (Pike13) account with us, use the same email address.

Which of our family of services are you enrolling in at this time? *

Please check all that apply.

music lessons

dance lessons

music therapy

Required