Snow Pond Center for the Arts · Community Arts School

Registration Type *

Initial Registration

Next Payment

Today's Date *

(mm/dd/yyyy)

Student Information

Name of Student

First Name

Last Name

Nickname

Age *

Date of Birth, if a minor

(mm/dd/yyyy)

☎ Parent/Guardian or Adult Student

Name *

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Preferred Phone *

2nd Phone

Email *

Verify Email *

Add 2nd Adult Who Can Transport Child

Yes

No

2nd Adult Who May Transport Child

First Name

Last Name

Email

Verify Email

Preferred Phone

2nd Phone

Add 3rd Adult Who Can Transport Child

Yes

No

3rd Adult Who May Transport Child

First Name

Last Name

Email

Verify Email

Preferred Phone

2nd Phone

Photo/Media Release *

I give Snow Pond Community Arts permission to use photographs and audio recordings of myself/ student for the purpose of fundraising and marketing materials (including print and online - via Snow Pond’s social media platforms.)

Yes

No

How did you hear about us?

Instrument Choice *

Lessons for a 2nd Instrument for this same student.

For initial registration, please click this link to read Snow Pond Community Arts Policies for Music Lessons. When finished, please authorize in the signature box below.

✍ Authorization

All information in this application is accurate to the best of my knowledge.

I have read and agree to the Snow Pond Community Arts Policies for Music Lessons.
(Please type your name) *