**We require all families to pay a one-time $99 Enrollment & Initiation fee. This fee supports our thorough and tailored Personalized Matching Process, which ensures we pair your family with the ideal instructor to meet your specific needs and goals - and it allows us to share the many membership benefits we provide. The enrollment and initiation fee is fully refundable if we are unable to successfully match you with a fantastic teacher you review and approve of.

*   denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address

City*

State* AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNENCNDNHNJNMNYNVOHOKORPARISCSDTNTXUTVAVTWAWIWVWYPRVI

Zip*

Contact #1

Parent or Primary Contact First Name*

Last Name *

Type* CaregiverFatherGuardianMotherParentSelf

How Can We Contact You?

Cell # *

By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from Bold Music LLC. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Student Gender* FemaleMale

Birth Date*

Additional Info

Instrument?

Lesson Length?

ALL avail lesson days/times

Any goals/additional info?

Student #2  (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender* FemaleMale

Birth Date*

Additional Info

Instrument?

Lesson Length?

ALL avail lesson days/times

Any goals/additional info?

Student #3  (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender* FemaleMale

Birth Date*

Additional Info

Instrument?

Lesson Length?

ALL avail lesson days/times

Any goals/additional info?

Student #4  (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender* FemaleMale

Birth Date*

Additional Info

Instrument?

Lesson Length?

ALL avail lesson days/times

Any goals/additional info?

Student #5  (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender* FemaleMale

Birth Date*

Additional Info

Instrument?

Lesson Length?

ALL avail lesson days/times

Any goals/additional info?

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Required Policies

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I Agree to All of the Above

Enter your Full Name* June 22, 2026

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number * VisaMastercardAmexDiscover

Exp Month * 010203040506070809101112

Exp Year *

Card Nickname

Name as it appears on card *

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*