L.E.A.D. Academy Music Lab Registration
Please fill out this form to add your child to the waiting list for music lessons. I will contact you via email when I have an opening available! I will be offering a summer session that starts June! If you are interested in trying a summer session, please let me know!
Email *
Choose a skill *
Required
Student’s Full Name *
Student’s Age *
Student’s Grade *
Name of School *
Mother’s Name and Phone Number *
Father’s Name and Phone Number *
Health or learning issues the instructor should know about (allergies, disabilities, giftedness, etc.) *
Briefly state your musical goals for your child and if you would like for him/her to participate in recitals. *
Do I have permission to put your child’s photo on the website?
Column 1
Yes
No
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Do I have permission to post videos and lesson pictures on social media?
Column 1
Yes
No
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Do I have permission to post videos and lesson pictures on social media?
Column 1
Yes
No
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