Parent’s Full Name
Child’s Full Name
Parent’s Email
Student's Gender MaleFemale
Mailing Address
Home Phone
Mobile Phone
Preferred Contact Method EmailHome PhoneMobile Phone
Student’s Birthday
Current grade in school: K123456789101112
What is your child’s current piano skill level? Brand newPlayed previously and want to return to the keyboardExperienced but seeking to hone skills
Does your child have a keyboard/piano to practice on at home? YesNo
I grant permission for Center for Musical Creativity/FunAndCreative Piano to use my child's picture and/or video from recitals and other piano events on the studio websites and social media pages. Specific personal information (student's name) will not be used to protect students' identities. YesNo
