Jazz Instrument Class Sign-Up

Thank you for your interest in our Jazz Music Classes! Please fill out the form below to register. Ensure all information is accurate and complete.

Student Information

First Name

Last Name

Date of Birth

Gender

Street Address

City

State/Province

Postal/Zip Code

Phone Number

Email Address

Parent/Guardian Name (if under 18)

First Name

Last Name

Emergency Contact Information

First Name

Last Name

Phone Number

Class Selection

Preferred Schedule

Weekdays (Mon-Fri)

Weekends (Sat-Sun)

Preferred Start Time

Musical Background

Years of Musical Experience

Primary Instrument(s)

Other Instruments Played

Have you taken jazz classes before?

Yes

No

If yes, please describe.

Do you read sheet music?

Yes

No

Are you currently part of any musical group/band?

Yes

No

If yes, please specify.

Payment Information

Class Fee per hour:

$0.00

Group Size (Private (1-on-1) : full price, Small group (2-6 people): 20% discount)

Private (1-on-1)

Small group (2-6 people)

Total Class Fee per hour:

$0.00

Payment Method:

Online Payment

Cash

Check

Terms and Conditions

I understand that payment is due before the start of the class.
I agree to adhere to the class schedule and notify the instructor in case of absence.
I understand that refunds are only available if requested at least 7 days before the class start date.
I grant permission for photos/videos taken during classes to be used for promotional purposes.

Signature

Thank you for registering! We look forward to helping you explore the world of jazz music!