#1 Student's first and last name
Birthdate
School and grade
Are there special circumstances of which the teacher should be aware (allergies, health issues, special needs, other accommodations)?
If "Yes" please explain
#2 Student's first and last name
#3 Students's first and last name
Mother's first and last name
Mother's cell phone number
Mother's email address
Father's first and last name
Father's cell phone number
Father's email address
Student's home address
Person responsible for payment
Email monthly statements to this address
Are there religious beliefs or other circumstances that might impact repertoire choices or performance dates or performance venues? (For example recitals held in churches).
Permission is given for each students' photo to be used for the studio website and Facebook page.
I would like to be included on the swap list for extended absences.
I have read and understand the Studio Policy and agree to abide by the terms of the Studio Policy
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