Yamaha Music School Lesson Registration Form
Please enter the following information to register for lessons at Yamaha Music School- Lacefield Music
Email address *
Location? *
Contact Name *
Your answer
Contact Phone # *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Relationship to Student *
Lesson Type *
Please list the instrument type (ex. piano) and if you are registering for group or individual.
Required
Student Name *
Your answer
Student Age *
Your answer
Medical Concerns/Prescriptions Needed *
Yes or No - If yes, please give brief summary (Medical Forms & Waivers will be emailed prior to camp dates to all emails).
Your answer
Special Diet or Restrictions? *
Yes or No - If yes, please list all restrictions and concerns.
Your answer
Other Information
Information about student that may be helpful for teacher to know.
Your answer
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