Registration
**Please disregard START and END dates/times below and enter N/A for instrument, lesson length and preferred lesson day when entering student details.**
**This class meets on Tuesdays from
1:30-2:15pm
starting October 5th, 2021 through the end of the school year.**
**Fee is $19 per class billed monthly for the number of classes held that month (in most cases 4 classes)
**There is a $25 registration fee. Included in the registration fee is your child's Junior Jammer T-shirt and all required materials.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Guardian
Mother
Self
Home Phone:
Cell #:
Work #:
Email:
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Instrument:
*
Lesson Length (45 or 60 min):
*
Preferred Lesson Day:
*
Additional questions/comments?:
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Instrument:
*
Lesson Length (45 or 60 min):
*
Preferred Lesson Day:
*
Additional questions/comments?:
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Instrument:
*
Lesson Length (45 or 60 min):
*
Preferred Lesson Day:
*
Additional questions/comments?:
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Instrument:
*
Lesson Length (45 or 60 min):
*
Preferred Lesson Day:
*
Additional questions/comments?:
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Instrument:
*
Lesson Length (45 or 60 min):
*
Preferred Lesson Day:
*
Additional questions/comments?:
Additional Information:
Class Policies
(Show-Hide Details)
**There is a $25 registration fee. Included in the registration fee is your childs' Junior Jammer t shirt.
1) Each class is limited to 17 students. Classes are filled on a first come basis, and each class is taught by 2 background checked instructors.
2) Students must enroll for the entire school year.
3) Payment for classes is collected in full for each month at the beginning of that month.
4) Students are expected to be present at both classes each week. Payment for classes is non refundable.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Amex
Discover
Name as it appears on card:
*
Nickname:
Card Expiration Month:
*
01
02
03
04
05
06
07
08
09
10
11
12
Exp Year:
*
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
Address Line 1:
Address Line 2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
*
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