Required Fields are marked with an asterisk.
Group Lessons
Private/ Semi-Private
Day of the Week Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00am 10:00am 11:00am 12:00pm 1:00pm 2:00pm 3:00pm 4:00pm 5:00pm 6:00pm 7:00pm 8:00pm
First Name
Last Name:
School:
Special Considerations:
Music Experience
Music Experience:
Parent's First Name:
Parent's Last Name:
Street Address:
City, State, Zip
Phone Number
EMail
Does the student have an allergy? (if yes, please specify) Does the student use an inhaler or an epi-pen?
Online Word of mouth Event Advertisement other
Tell us more about your student:
Comments:
Payment due upon registration includes yearly non-refundable $45 per student registration fee, book fee/deposit and tuition.
Please mail your payment to:
1050 Waltham St., Suite #100, Lexington, MA 02421
or
Visa Mastercard Discover American Express
Your Name: Date:
