Carrie’s Music Studio enrollment form Today's date: * MM DD YYYY What type of lessons are you registering for?: * Piano - one on one lessons (first grade - adult) Mini Musicians - Preschool and Kindergarten one on one lessons Mini Musicians - Preschool and Kindergarten group lessons Piano - online group lessons for adults Flute - one on one lessons (5th grade - adult) Clarinet - one on one lessons (5th grade - adult) Student's name: * First Name Last Name Student's birthdate: * Grade in school for the 2025-2026 school year (or n/a if adult student): * Pre-K Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 n/a Student's current schooling (or n/a): * Public / Private Homeschool College n/a Student's email address (or n/a): * Student's phone # (or n/a): * Mom / guardian's name (or n/a): * First Name Last Name Mom / guardian's email address (or n/a): * Mom / guardian's phone # (or n/a): * Dad / guardian's name (or n/a): * First Name Last Name Dad / guardian's email address (or n/a): * Dad / guardian's phone # (or n/a): * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Is the student studying any other instrument?: * Yes No If so, what instrument? (or n/a): * What extra-curricular activities is the student involved in? (or n/a): * Does the student have their OWN device(s), as listed below? Check all that apply: * Laptop iPad / tablet Phone None If you answered "None" above, does the student have ACCESS to any of the following devices at home (parent/guardian devices)? Check all that apply: * Laptop iPad / tablet Phone None Please list any food allergies or other allergies the student has below (or n/a): * Please list any learning or physical differences that I should be aware of to facilitate learning (or n/a): * Is there anything else you'd like me to know about your child?: Do I have your permission to post your child's (or your) photo/video, along with first name and last initial, on our studio website and social media?: * Yes No Have you read and do you agree to follow the guidelines in the studio handbook?: * Yes No Your enrollment has been received. Thank you!
