dA Guitar
Tuesday
5pm-6pm
Free/ Donations Appreciated
Ages 9

Fall Session :   September 10, 17, 24  October 1, 8, 15, 22, 29 November 5,12, 19, & 26

Beginning guitar
Email address *
Person 1: First and Last Name / Nombre y Apeido de estudiante *
Your answer
Age/ Edad
Additional information for students under 18
Your answer
Grade/ Grado
Additional information for students under 18
Your answer
School/Escuela
Additional information for students under 18
Your answer
Person 2: First and Last Name / Nombre y Apeido de estudiante
Your answer
Age/ Edad
Additional information for students under 18
Your answer
Grade/ Grado
Additional information for students under 18
Your answer
School/Escuela
Additional information for students under 18
Your answer
Person 3: First and Last Name / Nombre y Apeido de estudiante
Your answer
Age/ Edad
Additional information for students under 18
Your answer
Grade/ Grado
Additional information for students under 18
Your answer
School/Escuela
Additional information for students under 18
Your answer
Address/ dirección *
Your answer
City/ ciudad *
Your answer
State/ estado *
Your answer
Zip Code/ código postal *
Your answer
Telephone/ teléfono *
Your answer
Cell/ celular
Your answer
Emergency contact Name/ nombre de contacto de emergencia *
Your answer
Emergency Contact Telephone/ teléfono de contacto de emergencia *
Your answer
Emergency Contact (Relationship)/ Relación de contacto de emergencia *
Your answer
Special Needs or Health Alerts/ necesidades especiales o alerta médicas
Your answer
Parent's Name who will pay for class/ Nombre de padre que pagara para la clase
Additional information for students under 18
Your answer
Fees can be paid in cash at the dA Center for the Arts on your first day of class
A copy of your responses will be emailed to the address you provided.
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