Lesson Registration Please fill out the form below for online registration. Please note no payment is taken online, we will contact you to get enrollment finalized. Student Name* First Last Instrument*Years of Experience in Music*AgeBirthday MM DD YYYY Parent/Guardian Name* First Last Parent/Guardian Phone*Parent/Guardian Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian Email* Lesson Length (30, 45, 60 minutes)*Lesson Day / Time*Questions / CommentsLesson rates per lesson: 30 minutes = $ 30 45 minutes = $ 40 60 minutes = $ 50 Registration fee: $ 20/student Open Enrollment Year Round Discounts are available. Call for details.CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Print form and bring in.