Summit Fine Arts Music Academy Student Intake Form
Register your child for our fine arts music class (Grades 3-7). Please complete all sections and submit payment to secure your spot.
Parent/Guardian Information
Please provide your contact details.
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Student Information
Please enter information about the student enrolling.
Student Full Name
*
First Name
Last Name
Student Grade (Entering Fall 2025)
*
Please Select
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
Student Date of Birth
*
-
Month
-
Day
Year
Date
Does your child have any allergies or medical conditions we should be aware of?
Emergency Contact Name (if different from parent/guardian)
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Releases and Consents
Please review and provide your consent for the following.
Class Registration & Payment
Please complete your registration by submitting payment below.
My Products
Sort By
Name: A to Z
Name: Z to A
Price: Low to High
Price: High to Low
Clear Sort
prev
next
( X )
Fine Arts Music Academy Class Registration
Registration fee for one student (Grades 3-7) for the upcoming session.
$
230.00
Credit Card
Submit Registration
Should be Empty: