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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