Treasured Moments Studio
Welcome
Photography
Home
Meet Maria
Y O U
Sessions
Reviews
Blog
Piano
Home
About The Teacher
About the Studio
Piano Calendar
!! Celebrate !!
Community Resources
Student Area
Music & Arts Week
Contact Me
Photography Inquiry
Piano Inquiry
Treasured Moments Studio
Welcome
/
Photography
/
Home
Meet Maria
Y O U
Sessions
Reviews
Blog
Piano
/
Home
About The Teacher
About the Studio
Piano Calendar
!! Celebrate !!
Community Resources
Student Area
Music & Arts Week
/
Contact Me
/
Photography Inquiry
Piano Inquiry
Treasured Moments Studio
PNW Photographer & Piano Teacher
Piano Registration Form
Treasured Moments Studio
Welcome
/
Photography
/
Home
Meet Maria
Y O U
Sessions
Reviews
Blog
Piano
/
Home
About The Teacher
About the Studio
Piano Calendar
!! Celebrate !!
Community Resources
Student Area
Music & Arts Week
/
Contact Me
/
Photography Inquiry
Piano Inquiry
Parent or Guardian
Name
*
First Name
Last Name
Please specify your relationship to the student
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Primary Phone
*
(###)
###
####
Secondary Phone
(###)
###
####
In Case of Emergency
Emergency Contact
*
Emergency Contact's Relationship
*
Please specify the emergency contact's relationship to the student.
Emergency Contact Primary Phone Number
*
(###)
###
####
Emergency Contact Secondary Phone Number
(###)
###
####
Policy
*
Have you read through the Studio's Policy and do you agree to abide it?
Yes
No
Student #1
Student #1
*
First Name
Last Name
Student #1 Gender
*
Male
Female
Student #1 Birth Date
*
MM
DD
YYYY
Student #1 Age
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20+
Student #1 Allergies
*
At many of our recitals or 'Piano Tuesdays' goodies are served. Does your child have any food allergies?
Student #1 Lesson Length
*
30 Minutes
45 Minutes
1 Hour
Special arrangement with teacher
Student #2
Student #2
First Name
Last Name
Student #2 Gender
Male
Female
Student #2 Birth Date
MM
DD
YYYY
Student #2 Age
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20+
Student #2 Allergies
At many of our recitals or 'Piano Tuesdays' goodies are served. Does your child have any food allergies?
Student #2 Lesson Length
30 Minutes
45 Minutes
1 Hour
Special arrangement with teacher
Student #3
Student #3
First Name
Last Name
Student #3 Gender
Male
Female
Student #3 Birth Date
MM
DD
YYYY
Student #3 Age
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20+
Student #3 Allergies
At many of our recitals or 'Piano Tuesday's goodies are served. Does your child have any food allergies?
Student #3 Lesson Length
30 Minutes
45 Minutes
1 Hour
Special arrangement with teacher
Student #4
Student #4
First Name
Last Name
Student #4 Gender
Male
Female
Student #4 Birth Date
MM
DD
YYYY
Student #4 Age
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20+
Student #4 Allergies
At many of our recitals or 'Piano Tuesdays' goodies are served. Does your child have any food allergies?
Student #4 Lesson Length
30 Minutes
45 Minutes
1 Hour
Special arrangement with teacher
Student #5
Student #5
First Name
Last Name
Student #5 Gender
Male
Female
Student #5 Birth Date
MM
DD
YYYY
Student #5 Age
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20+
Student #5 Allergies
At many of our recitals or 'Piano Tuesdays' goodies are served. Does your child have any food allergies?
Student #5 Lesson Length
30 Minutes
45 Minutes
1 Hour
Special arrangement with teacher
Thank you!