Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Phone *

(###)

###

####

Student Name *

First Name

Last Name

Preferred day(s) for afternoon lessons? *

These are 1-hour lessons between the hours of 3-8pm.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Preferred start date: *

MM

DD

YYYY

Confirmation that the parent has read and agrees to the studio policies? *

Yes

No