Registration for Piano Lessons Debra Readman

Debra Readman Piano Studio

www.DebraReadmanPianoStudio.com
Adult Beginner Piano Group Class

September 12, 2022 - June 9, 2023
Which Class are you registering for? *

Adult Beginner Group Class Thursdays 6:20 - 7:20 pm
Student Name *

First Name Last Name
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
How do you prefer to receive communication, including automatic lesson reminders? *

Email Text Both Email and Text
Are there any personal circumstances I should be aware of such as learning disabilities, special needs, allergies (including food) or other health issues? *

Yes No
If yes, please type a confidential explanation here for the above question: *
Any other comments or notes?
How did you hear about my Adult Group Beginner Piano class? *

A friend or family member Google Search Facebook (other, please indicate)
PLEASE READ the document linked below as I adjust the Studio Policies and Tuition Rates every year. *
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Debra Readman Piano Studio