Registration Form 2020-21

Please let us know your name.

Please let us know your instrument

Choose a class.

If you chose a Group Class, provide the name here.

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

Enter the student's month and year of birth.

Enter your school grade.

Enter the name of your school.

Please enter your home phone number.

Enter your emergency phone number in the form XXX-XXX-XXXX

Enter your home address including STREET ADDRESS, CITY, STATE, and ZIPCODE.

Please enter the name of the Primary Parent to be contacted.

Enter the email address of the Primary Parent.

Please enter the Primary Parent's home phone number.

Please enter the Primary Parent's work phone number.

Please enter the Primary Parent's cell phone number.

Please enter the name of the Secondary Parent to be contacted.

Enter the email address of the Secondary Parent.

Please enter the Secondary Parent's home phone number.

Please enter the Secondary Parent's work phone number.

Please enter the Secondary Parent's cell phone number.

Please enter the name of the Alternate to be contacted.

Enter the email address of the Alternate Contact.

Please enter the Alternate Contact's home phone number.

Please enter the Alternate Contact's work phone number.

Please enter the Alternate Contact's cell phone number.

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 in order to confirm agreement with policies.