Imagine Music and Arts Private Lesson Sign-Up Form 2018-2019
This form is for current and new students to register for the 2018-2019 school year! Please fill out one per student.

If registering for CLASSES, please use the Group Class Registration Form instead!

Email address *
Student First and Last Name (please fill out one for each child in a family): *
Your answer
Current or New Student? *
If current, who is your teacher?
Your answer
Please list specific instrument or art: *
Your answer
Student Grade *
Student School (or homeschool):
Your answer
Date of any previous lessons:
MM
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DD
/
YYYY
Student Birthdate:
MM
/
DD
/
YYYY
Parent/Guardian Name(s):
Your answer
Best Phone Number: *
Your answer
Alternate Phone Number: *
Your answer
Address, including city and zip: *
Your answer
How did you hear about Imagine? *
Your answer
Are there any siblings that are current Imagine students?
Your answer
Lesson Day and Time Preferences
Your answer
Length of Lesson Desired: *
Other activities student participates in (if under 18):
Your answer
Special needs, learning or behavior disabilities, or dietary restrictions:
Your answer
Student or parent goals, wishes, hopes, dreams, desires for lessons:
Your answer
I give Imagine Music and Arts permission to use my child's image in photo or video for promotional purposes: *
Please bill Epic Charter Schools for my tuition:
I have read the Imagine Studio Policies at: https://imaginemusicandarts.com/tuition/studio-policies/ *
Other notes, questions, or comments for us:
Your answer
A copy of your responses will be emailed to the address you provided.
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