Private Winter Session

Private Lessons

January 6th-February 15th (6 weeks)
**A $30 enrollment fee is required for new students. You can pay this through paypal or by check.**
Type a question*

30 minute lessons once a week: $99/lesson (total $594)one hour lessons once a week: $198/lesson (total $1,188)
Please select the days you are available (subject to instructor availability):*

MondayTuesdayWednesdayThursdaySaturday
Please select the earliest time you could arrive at the barn:*

2:303:304:305:306:30
Student Information
Student's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship
Phone Number*
Alt. Phone Number
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the student prescribed an inhaler? If yes, please explain any instructions.*
New Student Enrollment Fee*
prevnext( X )
Pay with PayPal
$30.00



Pay with checkAdd $30 to you session total
$ Free



Current Student
$ Free



Total

$0.00
Should be Empty:

Private Lessons