Jazz BeCuzz Arts Group · 2023 - 2024 Registration For Student - Music Education At Jazz BeCuzz (17 & under)

Consenting Adult Confirmation *

Student Name (if under 18) *

First Name

Last Name

Student Age *

Student Birthdate *

(mm/dd/yyyy)

What is the student being instructed on? Please Confirm *

Parent (Guardian)Name *

First Name

Last Name

Parent (Guardian) Email *

Verify Email *

Parent (Guardian) Phone *

Finding the perfect time

We will try our best to coordinate the best time and teacher for the schedule that works best for you. Please select your first choice for day and time.

Lesson Schedule (Day of the week)

Best DAY

Lesson Schedule (Times) *

Best TIME of day

Discount Code

If you are using a special offer code please type below and enter the custom amount you were given in the Registration below. Thank you!

Registration *

$50 - One lesson

$130 - 1 month of classes (and materials)

$310 - 3 months of classes (and materials)

$600 - 6 months of classes (and materials)

$1,000 - Full 2022-2023 term of classes (and materials)

$

Share a kind note to your student we can share at the end of the lesson term! *

Payment Security

Your payment information is safe. This form is powered by Little Green Light and Paypal. Thank you!