Fall 2021 Music Lessons
Please complete this form to request a slot for Fall 2021 music lessons with Gabrielle. If a slot is available, she will contact you to complete the payment and enrollment process.
Student's Name *
Parent's Name (if student is under 18) *
Email address *
Mailing address *
Phone Number *
Emergency contact- name and phone number *
Student's birthday *
Type of lesson(s) *
Preferred length of lesson time (check all that apply) *
Provide us with 3 time slots you are available for Fall 2021 (i.e., Mondays 3:00-3:45, Tuesday 5:00-6:00) *
Snacks and treats may be offered during holidays and at recitals. Does the student have any food allergies or sensitivities? *
Do you give consent for photos and videos to be used for website, social media, or promotional materials? *
If you are a new student, how did you hear about us?
What other extracurricular activities is the student involved in?
Anything additional you'd like us know? (Previous musical experience, specific goals or musical interests?)
I have read and agree to the 2021 Studio Policies. *
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