Eustace Manning Henry Steelpan Academy
Registration Form
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Address
*
Street Address
Street Address Line 2
Parish
State / Province
Postal / Zip Code
Parish
*
Please Select
St. John's
St. Paul's
St. George's
St. Mary's
St. Peter's
St. Phillip's
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Emergency Contact
Emergency Contact Name
*
First Name
Last Name
Relation
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Musical Experience
Which Steelpan will you be interested in playing?
*
Soprano (Single Tenor)
Alto (Double Tenors)
Barritone (Double Seconds)
Cellos (Triple Guitar)
Four Bass
Six Bass
Double Guitar
Do You Read Music?
*
Yes
No
Which Class will you be joining?
*
Please Select
Beginners & Intermediates (Saturdays 10am - 11:30am)
Advance (Saturdays 12:30pm - 2pm)
Adult Beginners (Fridays 6pm - 7:15pm)
Submit
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