Test – Student Registration Page

Student First Name *

Student Last Name *

Student Birthday *

Parent/Guardian First Name *

Parent/Guardian Last Name *

Email (required) *

Home Phone Number

Cell Phone Number *

Student School *

Student Grade *

Does your student have any medical conditions that we should know about? *

Please indicate which services you are interested in; Piano/Keyboard, Voice/Singing, Acoustic Guitar, Electric Guitar, Bass Guitar, Drums, Violin, Viola, Cello, Clairinet, Flute, Trumpet, Saxophone, Ukulele, Fiddle, Banjo, or Other. *