Registration

All fields with an asterisk (*) must be completed before submitting.

Student Information*

Birth Date*

Medical Conditions:*

Musical Experience*

Parent Information (if a minor)

Contact Information*

How did you hear about us?*

Anything else we need to know?

Rental Piano Needed*

Piano Model if Renting (optional)

Address for Piano dropoff

I confirm that I have read, understand, and agree to the waiver of liability, studio policy, and rental agreement. View terms of use

I really have read all the policies!View terms of use

Respond if you wish not to have your photos taken and used by Lee's Academy of Music

E- Signature*

Date

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