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 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 cell phone number.

Please let us know your name.

Enter the student's month and year of birth.

Enter your school grade.

Please let us know your instrument

Please let us know your instrument

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I have read and understood the linked Wayland School of Music Summer Day Program 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.