Drop-In Student Booking Form (already registered)

Please check which instrument(s) you would like to register for:

Lesson Length

Lesson date(s) & time(s) requested (minimum 24 hours notice required): *

Alternate Lesson date(s) & time(s) if first request is not available: *

Name *

First

Last *

Last

Phone Number (please leave blank if your information does not need to be updated from your registration)

Email (please leave blank if your information does not need to be updated from your registration)

Name Student *

Address (please leave blank if your information does not need to be updated from your registration)

Number and types of pets (please leave blank if your information does not need to be updated from your registration)

Relevant Medical Information (please leave blank if your information does not need to be updated from your registration)

Name of and relationship to student of the person most likely to be home during the lesson

Emergency contact information. Name, Cell Phone, Relationship to student. (Someone other than the person most likely to be home during the lesson)

Musical background (if any) and muscial goals. Please list any current material you are working on or would like to start learning.

I would like to use the following method of payment to secure my drop-in lesson(s) *

I understand that: 1) once the date(s) above is/are confirmed by email/text, the lesson is transferable but not eligible for a refund/credit/makeup lesson and that I will need to purchase another drop-in lesson if I need to reschedule. 2) payment is required, in full, prior to the lesson(s) date *

Agree

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