Summer Registration

2012 Summer Lessons and Camps
Registration Form

Choose a Lesson Package *

30 minute lesson + 15min M.T.T. $90 45 minute lesson + 30min M.T.T. $123 60 minute lesson + 30min M.T.T. $156

Note: Payment is due at or before the first lesson in June.

Choose a Camp *

Piano Discovery Camp (Ages 5-7) Music Olympics (Ages 8-12) Composer Camp (Ages 12-16)

Note: Camp registration is complete once payment has been made.
$60 if paid by May 17th ($55 for current students) $70 after May 17th.

In order of preference, list your three favorite movie themes. *

* Indicates required field

Name of Student *

First

Last

Age *

DOB *

School *

Grade *

Parent(s) Name(s) *

Address *

Home Phone *

Cell Phone *

Email *

How often is email checked? *

Emergency Contact Info (other than parent) *

Health/Allergy Concerns *

Questions or Concerns *

Does the instructor have permission to feature photos and/or videos of this student (never using the full last name) on the studio website, email newsletters, and/or promotional items? *

Yes Please ask on a case by case basis No

Submit

2012 Summer Lessons and Camps
Registration Form

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2012 Summer Lessons and CampsRegistration Form

Popular Pages

Contact Us

Stay In Touch

2012 Summer Lessons and Camps
Registration Form