REGISTER | mysite

Registration for '24-'25 Private/Semi-Private Music Lessons with

Anamaria De La Cruz, MA

Student's First name

Student's Last name

Address

Primary Phone

Emergency Contact Phone Number

Student's Date of Birth

Select Your Class

Select Your Desired Class Time (Please note that your instructor will contact you if your desired time is no longer available)

Please read the following Waiver & Release Form: https://docs.google.com/document/d/1n5B6WBU8mhQpHz1s0RtxsqZtgC462OOpjo-MWN_hWEU/edit?usp=sharing

I have read to and agree to the Waiver & Release

Please read the following Class Policies & Fee Information: https://docs.google.com/document/d/15_UjSEgRBWP7bGJ3uEshcmNw3Eqq_THk0O4Bdiv0kOI/edit?usp=sharing

I have read and agree to all class policies.

Your (Adult) Printed Name

Signature (Adult/Parent/Guardian)

Date

I consent to me/my student appearing in promotional materials (print/media/online) regarding the music class

How Did You Find Us?

Please note that your spot is not confirmed until you have completed payment for the first month's class - under 'SHOP CLASSES'. Thank you!

*Please note the once you submit this form it may take a few moments to load the payment page. You will receive an email confirmation that your form was submitted.

If your submission does not re-direct you to the payment page, you may return complete your payment under the 'SHOP CLASSES' tab.