Lesson Registration 2020
Email *
Student's First Name *
Student's Last Name *
Student's Date of Birth *
MM
/
DD
/
YYYY
Does the student have any learning disabilities or impairments that we should be aware of? (audio, visual, ADD, etc.) *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Phone Number *
I prefer to be contacted by: *
Required
Emergency Contact Phone Number *
Country of Residence *
Street Address
City
Province/State
What is your current time zone?
What day would you like your lessons to be on? You can choose more than one if multiple days work. *
Required
Preferred Lesson START Time (Not all times can be accommodated but we will work as closely as possible with chosen times). Please pick your top 3 start times. If you are an international student please note that listed times are in Eastern Standard Time. Remember: If you would like 45 minute or 1-hour lessons, we are so happy to accommodate, please just let the front desk know by phone or email and we will book your lessons accordingly. *
Required
Student's Choice of Instrument: You are welcome to choose multiple instruments to learn and you can always add or change instruments after you've registered! *
Required
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