Class/Lesson Registration Please submit one form for each child you’d like to register or waitlist. Your Name * (parent/guardian) First Name Last Name Child's Name * First Name Last Name Child's Age Special Requirements * Does your child have any allergies or special requirements? Email * Mobile * (###) ### #### Emergency Contact * Who should we contact if we can't reach you? Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Which class are you interested in attending? Private (1:1) Lesson Children's Song Circle (0-7) Children's Songwriting Club (7-11) Preferred Time Slots Which time slots are you interested in? Saturday (AM) Sunday (AM) Monday (PM) School Holidays Other How did you hear about me? Extra Information Is there anything you'd like to add? Would you like to confirm attendance or check availability for a particular date? Thank you for registering! If you have already made a booking, you will receive a confirmation email with directions on how to get here, and payment instructions.All individual and block bookings should be paid for IN ADVANCE via BACS:Miss A F VardyACT 42312854SRT 070246 Please use your child's name/initial as your reference, and please let me know if you require a receipt. See you soon!ash
