Private Lessons Registration Form

Parent/Guardian 1

Name

First Name

Last Name

Relationship to Student

Email

Phone

(###)

###

####

Parent/Guardian 2

Name

First Name

Last Name

Relationship to Student

Email

Phone

(###)

###

####

Student 1

Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Helpful Information

Is there anything that would be good for me to know?

Student 2

Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Helpful Information

Is there anything that would be good for me to know?

Information for Studio Events

Accomodations

ie. relevant allergies, relevant dietary restrictions, religious accomodations

Acknowledgement of Studio Policies

I agree to the 2024/2025 studio policies

I understand that photos and videos may be taken at events, but will not be used without consent

I accept responsibility for my child up to the start time of the lesson, and as soon as the lesson ends