Registration

Parent/Guardian Name

Student Name

Student Birth Date

Phone

Address

Are you interested in Zoom or In-person lessons?

Preferred lesson day/time (Mon/Wed/Thurs between 2 PM and 830 PM)

List any specific goals or concerns

How did you hear about my lessons studio?

Please type your name here to indicate that, if you choose to start lessons, you have read and agree to the lesson policies and fees. (http://divadea.com/aplessons/aplessonspoliciesupdatedsept2023.pdf)