New Student Information Form

Student Signup

First
Last
Billing Address *
Billing Address
City
State/Province
Zip/Postal
I have read and I agree with the studio policies and procedures and agree to abide by them. *
From time to time the studio/teacher will photograph and post images or video of lessons or events to be used on Facebook, LaGrangePianoLesssons.com, and/or other social media outlets. We respect the student’s and parent’s right to privacy and would like to have permission to use images of the student online. *