Request a Trial or Regular Lessons

Request a Trial or Regular Lessons
Complete this form to tell us what lessons you are looking for and when you are available. Submitting this form does not commit you to booking lessons or accepting any lesson option we offer.

We will use the information you provide to identify a suitable tutor and then contact you with available lesson options. You can then decide whether any of the proposed options are suitable for you.

Please see our Student and Parent Privacy Notice for details of how we collect, use and protect your personal information.

You can register up to three students on one form. For students under 18, the form should be completed by a parent or legal guardian.

If you have any questions before completing the form, please contact us at info@en-actmusic.com or 07504 538135.
Details of the Person Completing This Form
Your Name

First NameLast Name
Phone Number

Area CodePhone Number
Email Address
example@example.com
Home address
I am filling out this form to
Student 1
If you are an adult registering yourself for lessons, please fill out the section for Student 1. If enrolling more than one student (for example, in cases of multiple children registrations), please fill out the following information for Students 2 and 3. Otherwise, please proceed to the next section entitled Your Current Weekly Availablity for the Lessons.
What is Student 1 full name?

First NameLast Name
What age is the student?
What instrument/or music classes is Student 1 looking for?
What weekly lesson duration is Student 1 looking for?
What is your preferred place for tutoring?
Tell us about Student 1 previous music learning and current proficiency level
Does Student 1 have any allergies, medical conditions, disabilities, additional needs or other circumstances that we should know about to help ensure their safety and support their learning?
Student 2
What is Student 2 full name?

First NameLast Name
What age is the student?
What instrument/or music classes is Student 2 looking for?
What weekly lesson duration is Student 2 looking for?
Tell us about Student 2 previous music learning and current proficiency level
Does Student 2 have any allergies, medical conditions, disabilities, additional needs or other circumstances that we should know about to help ensure their safety and support their learning?
Student 3
Name

First NameLast Name
What age is the student?
What instrument/or music classes is Student 3 looking for?
What weekly lesson duration is Student 3 looking for?
Tell us about Student 3 previous music learning and current proficiency level
Does Student 3 have any allergies, medical conditions, disabilities, additional needs or other circumstances that we should know about to help ensure their safety and support their learning?
Your current weekly availability for lessons

Please provide the earliest and latest possible times for lesson, for days where lessons are possible
Monday

Earliest time for lessonLatest time for lesson
Tuesday

Earliest time for lessonLatest time for lesson
Wednesday

Earliest time for lessonLatest time for lesson
Thursday

Earliest time for lessonLatest time for lesson
Friday

Earliest time for lessonLatest time for lesson
Saturday

Earliest time for lessonLatest time for lesson
Sunday

Earliest time for lessonLatest time for lesson
Emergency Contacts

Please provide us with two contacts we can approach in an emergency.
Emergency Contact 1

First NameLast Name
Relationship to Student(s)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address
Emergency Contact 2

First NameLast Name
Relationship to Student(s)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address
Acknowledgements
If a student becomes ill or injured, Enact Music or the tutor may provide appropriate first aid, contact the parent, legal guardian or emergency contact, call the emergency services and share relevant information with those involved in the student’s immediate care.

Where a student has been prescribed emergency medication, such as an asthma inhaler or adrenaline auto-injector, the parent, legal guardian or adult student is responsible for ensuring that it is available, in date and brought to every lesson or activity.
Our Terms and Conditions can be found here.
You are not obliged to accept any tutor or lesson time we propose. If you do accept a suitable lesson arrangement, please tell us whether you are happy for lessons to begin before the end of the 14-day cancellation period.
Optional Marketing Preferences
How did you hear about us?
Would you like to be notified about promotional services?
Should be Empty:

Request a Trial or Regular Lessons

Details of the Person Completing This Form

Student 1

Student 2

Student 3

Your current weekly availability for lessons

Emergency Contacts

Acknowledgements

Optional Marketing Preferences