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  • 2026 to 2027 Ottley Music School Academic Year Adult Registration Form

    Please read and fill out form carefully. If you have any questions, feel free to call us at (301) 454-0991 or to send us an e-mail at contact@ottleymusic.org.

  • Registrant Information

  • New or Returning Student*
  • I confirm that I intend to study at Ottley Music School for the:*
  • Student's Race or Ethnic Background. Please check all that apply. (OPTIONAL)

  • Sex*
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  •  -
  •  -
  • Preferred Number of Contact

  • Emergency Contacts

  • Emergency Contact #1

    For students under 18, and all students over 18, if the parents cannot be reached, list the name of at least one person who can be contacted in the event of an emergency.

  •  -

  • Emergency Contact #2

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  • Musical History

  • Have you studied music previously ?*
  • Student's Musical Ability in Primary Instrument*

  • Musical Goals

  • Do you own the instrument needed for lesson ?*
  • Do you need to rent an instrument ?*

  • Keyboards can be rented from the school. There are also instruments for sale. Send any inquiries to contact@ottleymusic.org.

  • How did you hear about us?

  • Scheduling and Lesson Cost

  • Preferred Location*
  • Lesson Length
  • Medical / Health Disclaimer

    Medical / Health Disclaimer

  • I declare and affirm that I have an active medical insurance*
  • Do you have a special health or medical condition that would influence your ability to perform in the class or may regularly intervene with your committed class time?*

  • Statement of Understanding

  • Date Signed*
     - -

  • Payment

  • Payment is not required to submit this registration form. However, lessons will not be scheduled until receipt of payment. You will be invoiced when your submission is received.

    Thank you for considering the Ottley Music School. We look forward to seeing you in our halls.

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