“Can’t Stop the Music” Series Registration Form

Student Name*First Name

Last Name

Gender*

Date of Birth*Please use format MM/DD/YYYY

Student’s Email Address (optional)If you would like class reminders & materials to also be sent to your student

Student’s Phone Number (optional)If you would like class reminders & materials to also be sent to your student

Instrument(s)*

Guitar

Piano

Voice

Please select all that apply

Additional Interests

Audition/Performance Prep

Music Theory

Performance Certification

Performance Diploma

Parent/Guardian*First Name

Last Name

Email Address*

Phone Number*

Additional Parent/GuardianFirst Name

Last Name

Email Address

Phone Number

Message (optional)Please use this space to add any additional contact information or questions.

View Lesson Policies & Fee ScheduleI accept the Lesson Policies & Fee Schedule*I have read and agree to comply with the Music 4 Kidz Policies & Fee Schedule.

View Media ReleaseI accept the Media Release Form (optional)I have read and accept the terms of the Music 4 Kidz Media Release Form

Parent/Guardian Signature*By typing my full name, I consider this to be my legal signature that the above information is accurate.

Can’t Stop The Music Series – Registration Form

New Student Registration