Suzuki Music Program of Los Angeles

Suzuki Music Program of Los Angeles

SMPLA Annual Registration Form. Includes Solo Recitals, Public Performances at Senior Living Centers, Malls, Parks, etc, Parent Support Forums, and other musical opportunities. PLEASE SUBMIT ONE FORM PER STUDENT.
Student Name*

First NameLast Name
Gender*
Birthday*
MM/DD/YYYY
Parent 1 Name *

First NameLast Name
Parent Email*
example@example.com
Parent 2 Name (optional)

First NameLast Name
Additional Email (optional)
example@example.com
Primary Mobile Phone*
XXX-XX-XXXX
Secondary Mobile Phone
XXX-XX-XXXX
Street Address*
City*
Zip Code*
TEACHER NAME*

First NameLast Name
TEACHER Email
example@example.com
Primary Mobile Phone*
XXX-XX-XXXX
Instrument*
Most Recent Book / Piece being learned*
Questions/Comments
You are required to read the following information carefully and make sure that you understand it fully and agree to it before allowing your child(ren) to participate in this activity or program.

Medical Waiver Photo & Video Release for Minors

By submitting this form, you are signing this form electrionically and agree that you have read, understand, and accept the General Libality and Medical Treatment Informed Consent and Photo/Video waivers.

My Selections

SMPLA "Extra Activities"$84.00

Annual Fee that includes Solo Recitals, Public Performances (senior living centers, malls, parks, etc.), Family Music Night, Parent Support Forums during the 2024 - 2025 season.

SMPLA Red Tie$15.00

For Public Performances & Concerts

SMPLA T-Shirt!$18.00

SMPLA T-Shirt

CHECK THE BOX ABOVE and then select size hereSize

SMPLA Parent Education Seminar "Motivate and Mentor" $55.00

PARENT Education Seminar four-week Seminar will be held virtually in the Winter/Spring Semester 2025.

I love SMPLA$ Free

I WANT TO DONATE TO MUSIC EDUCATION. This is a donation to SMPLA, a non-profit organization, to support music education. CHECK the box above and select your amount below.

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