Private Lessons Registration Form

Please fill out one form per student! Thank you!

Parent/Adult student/Guardian Name *
Parent/Adult student/Guardian Name
Primary Phone Number *
Primary Phone Number
Secondary Phone Number
Secondary Phone Number
Please include name of the person, relationship to the student and contact phone number
Student's Name *
Student's Name
Birth Date *
Birth Date
Please choose who you would like to study with:
30min is recommended for students 8 y.o. and under 45min is recommended for students 9-13 y.o. 60min is recommended for students 13 y.o. and older
How would you like to pay? *
Please choose 1 or more options
Signature *
By signing your name below you agree to the terms of Argyle Music Academy's policy (can be found on the website)
Today's Date *
Today's Date