Registration formInterested in learning with us? Fill out some info and we will be in touch shortly! We can't wait to hear from you. Terms and Conditions Student * First Name Last Name DOB * MM DD YYYY Other Information * Known allergies, disabilities, etc. Parent/Guardian If applicable First Name Last Name Relationship to Student Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Instrument (Primary) * Piano Acoustic Guitar Classical Guitar Electric Guitar Bass Guitar Ukulele Singing Clarinet Saxophone Flute Recorder Drums & Percussion Trumpet Trombone Tuba French Horn Violin Viola Cello Double Bass Harp Instrument Level * Beginner Intermediate Advanced Instrument (Secondary) Piano Acoustic Guitar Classical Guitar Electric Guitar Bass Guitar Ukulele Singing Clarinet Saxophone Flute Recorder Drums & Percussion Trumpet Trombone Tuba French Horn Violin Viola Cello Double Bass Harp Instrument Level Beginner Intermediate Advanced Have you completed any grades? * Yes No If yes, which grades? Are you interested in our other services? Tick all applicable Theory Music Appreciation Mums & Bubs Songwriting & Composition Band/Ensemble Preferred Lesson Length * 30 min 45 min 60 min Preferred Lesson Day * Please note that we cannot guarantee that this lesson time is available. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Time * Hour Minute Second AM PM Other Availability * Please list as many options as possible Preferred Lesson Location * Croxley Green Studio Ritz Music Studio (Richmond) Partnered School Home Online If you have chosen 'partnered school', please state which one; How did you hear about us? Recommendation Website Social Media School Services Emergency Contact * First Name Last Name Relationship to Student * Phone * (###) ### #### Agreement to Terms * Please tick all options before submitting Any information given will not be shared with anyone unless permission is given The information I have provided is accurate and I will advise B Sharp Studios of any changes. I have read and agree to B Sharps Studio's terms and conditions. Thank you!