Registration Form

Registration Form (one to one)

Academic Year 2023 - 2024
Student's *

First NameLast Name
Student's Date of Birth

DayMonthYear
Lesson you want to take*
Duration of Lesson*
Location*

OnlineHarrow StudiosHome Visit (Drums/Piano/Guitar)
Parent/Guardian's *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Post code
Phone Number*

Phone Number Retype phone number
Email*
Does the Student have any disabilities?

(It is vital that we are aware of any disabilities so that teachers are able to structure lessons to suit the student's specific needs and achieve the best results for the student. All information will be strictly confidential).
Does the Student have any disabilities?*

YesNo
If yes, please describe the nature of the disability/disabilities below
Should be Empty:

Registration Form (one to one)