Registration Form for 2018-2019

Please fill out and return the fall registration form to the studio. Indicating several options for lesson times will help me arrange the studio in a way that is best for every one.  Please note that registration is on a first come-first serve basis.  I plan to teach during the following times:

    Mondays: 1:00PM-8:30PM Souderton only

    Tuesdays: 1:00PM-8:30PM Wyncote

    Wednesdays: 1:00PM-6:00PM Wyncote

 

Student Name *
Student Name
Birth Date *
Birth Date
Parent / Guardian *
Parent / Guardian
Phone (Home)
Phone (Home)
Phone (Mobile)
Phone (Mobile)
Phone (Work)
Phone (Work)
Address *
Address
Last Date Tuned / Serviced
Last Date Tuned / Serviced
Preferred Lesson Time *
Preferred Lesson Time
Lesson Time Exchange
Yes, please include me in the lesson time exchange program. I understand that my name and phone number will be available to other students.
Student Enrollment Agreement *
I am enrolling my child in the Waggoner Music Studio for the 2017-2018 school year. I have read and agree to abide by the policies stated in the studio policy regarding attendance, practice, payment, and parental support.
Date of Agreement *
Date of Agreement
Please Note:
There are a limited number of lesson slots available. Lessons will be scheduled on a first come, first serve basis. Registration fee: Individual: $50 Each additional family member $30 Please indicate if you paid this registration fee in the summer.