Student's Name *

First

*

Last

Current Age of Student *

Number of Lessons for the Summer *

Choose the total number of lessons you would like to attend between the dates of May 27th - July 29th.

Email *

Preferred Lesson Type *

Piano Group Lessons

Private Piano Lessons (1 on 1)

Private Guitar Lessons (1 on 1)

Private Voice Lessons (1 on 1)

NOTE:

We have very limited availability for private piano lessons for children under 7. Please email Miss Christina for times and availability at office@lagrangepiano.com.

Preferred Dates for Lessons

Pick your preferred time for group lessons *

Tuesdays 3:30

Tuesdays 4:30

Tuesdays 5:30

Tuesdays 6:00

Parent/Guardian First Name

Parent/Guardian Last Name

Cell Phone Number

Billing Address

City

State/Province

Zip/Postal

Credit Card *

Total Cost

I have read and I agree with the studio policies and procedures and agree to abide by them. ***NOTICE*** They have been updated for the fall semester *

Yes

Click here to read our Studio Policies and Procedures

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. *

Yes, I agree to allow the use of my child's image

No, I do not allow the use of my child's image

Sign up for summer lessons

NOTE: We have very limited availability for private piano lessons for children under 7. Please email Miss Christina for times and availability at office@lagrangepiano.com.

NOTE:

We have very limited availability for private piano lessons for children under 7. Please email Miss Christina for times and availability at office@lagrangepiano.com.