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Formerly Atlanta Dance & Music Academy
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Music Registration Form
First and Last Name
*
First and Last Name of person taking class
Age of Person Registering
*
Child/Teen Student
Adult Student
Parent's Name
*
Email
*
Enter Email
Confirm Email
Parent's Email
*
Enter Email
Confirm Email
Phone
*
Parent's Phone
*
Student's Birthdate
*
mm/dd/yyyy
Previous Experience
*
Beginning Student
Intermediate/Returning Student
Advanced/Professional Student
I am registering for
*
Ongoing Music Lessons
Limited Coaching Session
Class:
*
Violin
Piano (Beginning)
Piano (Intermediate)
Strings
Voice
Acoustic Guitar
Electric Guitar
My instrument is not listed
These are our most popular lessons offered. If you do not see your instrument of choice, please enter below.
Enter instrument here if not listed above
Children & Teen Availability
Monday - after 4p
Tuesday - after 4p
Wednesday - after 4p
Thursday - after 4p
Saturday - between 10a -2p
Sunday - between 12p -4p
I would like to discuss another lesson time
Check ALL that apply:
Availability
Monday
Tuesday
Wednesday
Thursday
Saturday
Check ALL that apply:
Instruction Method
*
Online (Zoom, Google Meet) Only
In-person Only
Either option
Have you registered another child in your family for dance or music classes?
*
Yes
No
Are you a returning student or a new student ready to register today?
*
Yes, I'm ready to register!
No, I prefer a short consultation to meet the teacher before we commit to lessons.
All families are charged an annual $50 registration fee. If you have registered any children for another dance or music class, you will not be charged again.
Price:
All new students require a consultation to discuss the goals of lessons.
Price:
Consent
*
I have read and agree to the music tuition and fee policy.
Credit Card
*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
Expiration Date
Security Code
Cardholder Name
2078