Parent/Guardian Info

    Name*

    Street Address

    City

    Zip Code

    Daytime Phone

    Cell Phone

    Email*



    Student Info

    Student 1

    Student 1

    Name

    Birthday

    School Currently Attending

    Age

    Instrument
    PianoGuitarDrumsBassVoiceOther

    Level
    Beginner (0-1 year of lessons)Intermediate (2-3 years of lessons)Advanced (3+ years of lessons)

     

    What Programs Are You Interested In?

    Packages

    Lesson N' LIVE Packages

    Lessons

    InHome Lessons

    Preferred Teacher

    Skillz and FUNdamentalz

    Bands

    KidzRock (4-7)

    KidzBandz I: 1 hour (8-10)

    Kidz Bandz II: 90 min (11+)

    Other Classes

    Music Production and Recording (10+)

    Songwriting Intensives (10+)

    The WeeMix (2-4)

    Vacation Camps (5+)

     

    Preferred Days/Times

    Please give a range so we can best accommodate your request.
    (eg: M 3-4, W 2-6, F 3-4)

    Student 2

    Student 2

    Name

    Birthday

    School Currently Attending

    Age

    Instrument
    PianoGuitarDrumsBassVoiceOther

    Level
    Beginner (0-1 year of lessons)Intermediate (2-3 years of lessons)Advanced (3+ years of lessons)

     

    What Programs Are You Interested In?

    Packages

    Lesson N' LIVE Packages

    Lessons

    InHome Lessons

    Preferred Teacher

    Skillz and FUNdamentalz

    Bands

    KidzRock (4-7)

    KidzBandz I: 1 hour (8-10)

    Kidz Bandz II: 90 min (11+)

    Other Classes

    Music Production and Recording (10+)

    Songwriting Intensives (10+)

    The WeeMix (2-4)

    Vacation Camps (5+)

     

    Preferred Days/Times

    Please give a range so we can best accommodate your request.
    (eg: M 3-4, W 2-6, F 3-4)

    Student 3

    Student 3

    Name

    Birthday

    School Currently Attending

    Age

    Instrument
    PianoGuitarDrumsBassVoiceOther

    Level
    Beginner (0-1 year of lessons)Intermediate (2-3 years of lessons)Advanced (3+ years of lessons)

     

    What Programs Are You Interested In?

    Packages

    Lesson N' LIVE Packages

    Lessons

    InHome Lessons

    Preferred Teacher

    Skillz and FUNdamentalz

    Bands

    KidzRock (4-7)

    KidzBandz I: 1 hour (8-10)

    Kidz Bandz II: 90 min (11+)

    Other Classes

    Music Production and Recording (10+)

    Songwriting Intensives (10+)

    The WeeMix (2-4)

    Vacation Camps (5+)

     

    Preferred Days/Times

    Please give a range so we can best accommodate your request.
    (eg: M 3-4, W 2-6, F 3-4)

    Student 4

    Student 4

    Name

    Birthday

    School Currently Attending

    Age

    Instrument
    PianoGuitarDrumsBassVoiceOther

    Level
    Beginner (0-1 year of lessons)Intermediate (2-3 years of lessons)Advanced (3+ years of lessons)

     

    What Programs Are You Interested In?

    Packages

    Lesson N' LIVE Packages

    Lessons

    InHome Lessons

    Preferred Teacher

    Skillz and FUNdamentalz

    Bands

    KidzRock (4-7)

    KidzBandz I: 1 hour (8-10)

    Kidz Bandz II: 90 min (11+)

    Other Classes

    Music Production and Recording (10+)

    Songwriting Intensives (10+)

    The WeeMix (2-4)

    Vacation Camps (5+)

     

    Preferred Days/Times

    Please give a range so we can best accommodate your request.
    (eg: M 3-4, W 2-6, F 3-4)



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