“I Have Confidence” Series Registration Form

I Have Confidence Series – Registration Form

Please complete the form below to register your student for Music Theory, Audition/performance Prep, and/or Certification/Diploma Programs

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

Course*

Grade/Level*

Desired Class Day/Time*Once confirmed that your desired timeslot is available, please submit payment to lock in your weekly time.

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.

Acceptance of Rates & Terms*I agree to the rates/terms for this special program as provided to me via email. I understand that to complete my registration and reserve my child’s spot, payment will be submitted along with this registration form.

View Media ReleaseAcceptance of Media Release (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.

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