Welcome to TTWM!
Please carefully complete each section of this form.
Name of Parent or Adult Student *
Phone *
Address *
Street, City, State, Zip Code
Email - Please enter carefully! *
For which class(es) would you like to sign up? *Please note: Make-up policy for piano/guitar lessons is that 24 hours notice is required to properly cancel and ensure that a missed lesson will be made up. However, sudden illness or emergency will be taken into consideration. TTWM classes are made up at the end of the semester in the event of a canceled class. *
Please check all that apply.
Required
OPTIMAL DAY/TIME: ANY additional information you can provide regarding your availability and/or preference of day and time frame can be helpful with scheduling. You may add that here, but please be aware that Andrea Duke will finalize your time, based on availability.
Choose location(s) - Check all that apply. *
Maps and addresses are found on the TTWM, Piano, and Guitar website tabs.
Required
Student #1 - Name, Age, Birthdate (please include year) *
Is this student signing up for...? *
Required
Student #2 - Name, Age, Birthdate (include year)
Is this student signing up for...?
Student #3 - Name, Age, Birthdate (include year)
Is this student signing up for...?
Student #4 - Name, Age, Birthdate (include year)
Is this student signing up for...?
Student #5 - Name, Age, Birthdate (include year)
Is this student signing up for...?
Emergency Information *
Andrea Duke will contact 911 in case of an emergency. Should she be aware of anything in case of an emergency (such as allergies)?
Photos/Videos Consent *
Could Andrea Duke use photos/videos of you or your child(ren) actively engaged in a music class or lesson for marketing purposes on her website or social media page? (Just likeness, no names!)
How did you find out about this program....a current student or other advertising?
By referring new students to The Treble with Music, current students can receive a discount on the next session!
I hereby waive, release, and forever discharge all claims against Andrea Duke and The Treble with Music, LLC, for any injuries, damages, losses or claims, whether known or unknown, which arise during or result from any activity of or services provided by her and it. *
Please indicate that you have read and agree to these terms.
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