Registration Form 2020-21

Student's Name:*
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 (2019-20):
Home Phone:
Emergency, First Call Phone:*
Home address:*
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 linked Wayland School of Music 2020-21 Policies. My electronic or written signature below indicates my agreement to be bound by these Policies, and my understanding that they apply to both on-site and on-screen (online) lessons.

Type your name to agree:*
Word Verification: