VIRTUAL Music Lesson Registration Form
All CURRENT and NEW Students should fill out the below form. Current Students do not need to fill out basic contact information. Once registration is complete, the director will contact you to schedule your lessons.
Student's Name *
Your answer
Type of lesson student is registering for:
Are you a current music student of Sing Explore Create? (current clients can skip the contact info questions)
Date of Birth
MM
/
DD
/
YYYY
Parent/Guardian's Name (if under 18)
Your answer
Email *
Your answer
Street Address
Your answer
Town/City
Your answer
State
Your answer
Zip Code
Your answer
Phone # *
Your answer
Secondary Phone
Your answer
Does the student have access to the instrument they would like to learn? (students music have instrument to play on) *
Does the client have access to an internet connection (high speed preferred) ? *
Does the client have access to a device with webcam that can connect to the internet (laptop, smartphone, computer, ipad)? *
Permission to be recorded *
At times we record sessions or songs from sessions to share with the rest of the Sing Explore Create, LLC music team. This is strictly for educational and supervision purposes. Recordings will not be shared outside of our supervision meetings, unless additional permission is granted by the client or guardian. Please check one of the following:
The client would like to register for: *
Although we are unable to offer music lessons free of charge to families, we are offering a sliding scale. Please indicate what you can afford based on the sliding scale listed beside each package option above. Regardless of which package you choose, the sessions can be scheduled to meet 1 time or more per week. You may purchase additional sessions, once all sessions in your package have been used. The amount I choose to pay for the Package I chose is: *
Your answer
To assist us with scheduling, please list any scheduling conflicts you have during the week. Ideally, sessions will be planned at a time when there are few distractions happening in the home. For younger students, parents/caregivers should be available to assist in the lesson if needed.
Your answer
For new students, please let us know if you have played your instrument before and your level (beginner, intermediate, advanced). *
Your answer
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