Intermezzo Piano Academy 2017 Registration Form
Cell Phone Number
Used in case of emergency
We will send you confirmation of registration via email.
Parent Mailing Address
Were you referred by anyone? Please specify.
Help us get to know your student!
Years of Piano Study
If your student has no prior piano study please enter 'zero'.
Write the NAME and LEVEL of your students CURRENT PIANO BOOKS.
Example : Faber Piano Adventures: Level 2 *If your student is not is a method book then write in the current classical pieces they are working on. *If student has no prior training please write "none"
Name of student's current teacher if known.
Choose your student's T-shirt Size
Does you student have any special needs, allergies or medical conditions that the staff should be aware of?
Choose your Camp Location and Date
Choose your location
Springfield, MO -- June 2017
Athens, GA -- July 10-14, 2017
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