Class Registration Information
Student Information
Student Name
*
First Name
Last Name
Student Date of Birth
*
-
Month
-
Day
Year
Date
Student Grade Level
*
Student Email
example@example.com
Contact Information
Parent/Guardian or Adult Student
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone
*
Please enter a valid phone number.
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Alternate Contact Name
*
First Name
Last Name
Alternate Contact Phone Number
Alternate Contact Email Adress
*
example@example.com
Class Information
Which class is the student interested in?
*
Optional Information
Is there anything you would like to share about the student (e.g learning considerations, special needs)?
How did you hear about DSM?
Policies
Please review the DSM policies for families 2024-25 linked below
Review of DSM policies.
*
Check here to indicate you have read and agree with DSM policies.
Registration Fee
DSM Charges an annual registration fee of $30 per student, up to a maximum of $60 per family.
Acknowledgment of fees
*
Check here to acknowledge that you will be charged a $30 registration fee annually in addition to lesson and/or class tuition.
Photo & Video Permission
Does DSM have permission to use the student's photo(s) or video(s) on its website, social media and/or newsletter?
*
It is OK to use the students photo or video
It is NOT OK to use the students photo or video
Submit
Our office will contact you soon to confirm registration and facilitate scheduling. If you have any questions in the meantime, please call us at 781-441-9372 or email us at info@dedhamschoolofmusic.org.
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