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Child's name

Email

Birthday

Gender

Child's Age

Where did you hear about us?

Mom's Name

Dad's Name

Mom's Cell

Dad's Cell

School my child attends:

Please list any other activity that your child is involved in:

Has your child ever studied an instrument before? If so, please list in detail how long, what instrument, name of the teacher and the level reached.

Please list siblings and ages:

Are there any musicians in the family? Please explain.

Are there any medical, allergies, or emotional conditions the teacher should be aware of?

Check the boxes below in order to enroll for lessons"
We commit to creating a nurturing music environment.We commit to reading our materials.We commit to practicing regularly.We are responsible to attend all lessons and classes.We are responsible to attend recitals.Parents are to stay with their children at all times.Fees for any payments (credit card, insufficient funds, bounced checks) will be charged as tuition.

Please write anything that you think the teacher should know: