Preschool and K-12 Registration Form

This form is for students taking weekly lessons at my home studio. When you submit this form, you are agreeing to follow the studio policies published on the website.

Child's Name*
First Last
Name of School and Grade for 2023-2024*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Parent/Guardian Name*
First Last
Preferred Phone Number for Messages About Lessons*
Does that number accept text messages?*
- Yes
- No
Alternate Phone Number if Parent Cannot Be Reached*
Parent/Guardian Preferred Email Address*
Weekly Lesson Length*
How will you be paying?*
Beside's piano, what else is your child involved in outside of school?*
Please describe any academic or health-related concerns that I should be aware of when teaching your child.
Please describe your instrument in detail: acoustic vs. digital, make, model, condition, etc.*
What goals do you have for your child this year? Please share any ideas, dreams or aspirations you and/or your child have, musical or otherwise!*
May I show your (unidentified) child in a photo or video on my website or Facebook page?*
- Yes
- No
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