Registration Form 2022-23

Please let us know your name.

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. If you chose Private Lessons, provide the length of the lesson.

Please also fill out the Private Lesson Scheduling Form or the PlayTogether Go Scheduling Form, if registering for either program.

Enter the student's month and year of birth.

Enter your school grade.

Enter the name of your school.

Enter your home STREET ADDRESS.

Enter your home address CITY.

Enter your home address STATE.

Enter your home address ZIP CODE.

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

Please enter the relationship of the Primary Caregiver to the student.

Enter the email address of the Primary Contact.

Please enter the Primary Contact's cell phone number.

Please enter the Primary Contact's alternate phone number.

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

Please enter the relationship of the Secondary Caregiver to the student.

Enter the email address of the Secondary Contact.

Please enter the Secondary Contact's cell phone number.

Please enter the Secondary Contact's phone number.

I have read and understood the linked Wayland School of Music 2022-23 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.