Get ready to rock! Welcome to [Your Music School/Organization Name]! We're excited you're interested in joining our pop music classes. Please complete this form to register.
Date
First Name
Middle Name
Last Name
Date of Birth
Gender
Street Address
City/Suburb
State/Province
Postal/Zip Code
Phone Number
Email Address
First Name
Last Name
Phone Number
Email Address
Instrument/Voice
Vocals
Guitar
Bass
Drums
Keyboard
Songwriting
Music Production
Instrument/Voice
Beginner
Intermediate
Advanced
Specific Class
Class Name | Day and Time | Select | Tuition Fee per hour | Amount ($) | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | Beginner Guitar | Tuesdays 4:00 PM | $60.00 | $0.00 | ||
2 | Songwriting Workshop | Thursdays 7:00 PM | $100.00 | $0.00 | ||
3 | Vocals lesson | Wednesday 5:00 PM | $60.00 | $0.00 | ||
4 | Learning Drums | Friday 7:00 PM | $70.00 | $0.00 | ||
5 | Music Production | Saturday 1:00 PM | $150.00 | $0.00 | ||
6 | Subtotal | $0.00 | ||||
7 | Registration Fee | $50.00 | ||||
8 | Total Amount Due | $50.00 |
Do you have any prior musical experience?
If yes, please describe.
What are your musical influences/favorite artists?
What are your goals for taking this class?
First Name
Last Name
Phone Number
Relationship to Student
Do you have any prior musical experience?
If yes, please describe.
Is the student currently taking any medications?
If yes, please describe.
I understand and agree to abide by the policies and procedures of [Your Music School/Organization Name], including attendance, payment, and cancellation policies, as outlined in the student handbook/website.
I grant permission for [Your Music School/Organization Name] to use photographs and/or videos of the student for promotional purposes (e.g., website, social media, brochures).
I release [Your Music School/Organization Name], its staff, and instructors from any liability for accidents or injuries that may occur during classes or activities.
Student Signature (if 18 or older)
Parent/Guardian Signature (if student is under 18)
Thank you for your registration! We look forward to jamming with you!
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