Student Registration

First Name

Last Name

Email Address

Primary Phone

Secondary Phone (optional)

Street Address

City

Zip Code

Student First Name

Student Last Name

Age (or adult)

Instrument

List other instrument(s) & Styles (optional)

Location Preference

Lesson Length

Lesson Length Details (optional)

Availability (Preferred Days/Times)

Teacher Request

• One business day to cancel - first lesson guaranteed.

• Card charged the following business day if happy

• 30-day notice to cancel ongoing lessons.

I have read and agree to the Studio Policies.

Name on Card

Card Number

Expiration (MM/YY)

Street Address

Billing Zip