Registration Form 2017-18

Student's Name:*
Instrument:*
Registering for:*
Name of Group Class:

Please check those that apply; also, fill out the Private Lesson Scheduling Form and/or the Chamber Music Scheduling Form.

Month/year of birth
School Grade (2017-18):
School:
Home address:*
Home Phone:
-
Emergency, First Call Phone:*
-
Primary Parent Contact:*
Primary Parent E-mail:*
Primary Parent Home Phone:
-
Primary Parent Work Phone:
-
Primary Parent Cell Phone:
-
Secondary Parent Contact:
Secondary Parent E-mail:
Secondary Parent Home Phone:
-
Secondary Parent Work Phone:
-
Secondary Parent Cell Phone:
-
Alternate Contact:
Alternate Contact E-mail:
Alternate Contact Home Phone:
-
Alternate Contact Work Phone:
-
Alternate Contact Cell Phone:
-

I have read and understood the WSM 2017-18 Attendance/Make-Up Policies. My electronic or written signature below indicates my agreement to be bound by these policies.

Type your name to agree:*
Word Verification: