Lupton Street Studios Online Registration

Student #1

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs / Allergies / Medications (Leave blank if NONE)

Media Release 26-27*

Wait list for Music Lessons?

MEDIA RELEASE - type YES, or NO in the box above
I give consent for myself / my child(ren)'s name or photo or video to be used in association with Lupton Street Studios on the studio website, in the media and social media outlets.

WAIT LIST FOR MUSIC LESSONS - type YES if you would like to be on the wait list for private music lessons.

Enroll in Classes

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs / Allergies / Medications (Leave blank if NONE)

Media Release 26-27*

Wait list for Music Lessons?

MEDIA RELEASE - type YES, or NO in the box above
I give consent for myself / my child(ren)'s name or photo or video to be used in association with Lupton Street Studios on the studio website, in the media and social media outlets.

WAIT LIST FOR MUSIC LESSONS - type YES if you would like to be on the wait list for private music lessons.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs / Allergies / Medications (Leave blank if NONE)

Media Release 26-27*

Wait list for Music Lessons?

MEDIA RELEASE - type YES, or NO in the box above
I give consent for myself / my child(ren)'s name or photo or video to be used in association with Lupton Street Studios on the studio website, in the media and social media outlets.

WAIT LIST FOR MUSIC LESSONS - type YES if you would like to be on the wait list for private music lessons.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs / Allergies / Medications (Leave blank if NONE)

Media Release 26-27*

Wait list for Music Lessons?

MEDIA RELEASE - type YES, or NO in the box above
I give consent for myself / my child(ren)'s name or photo or video to be used in association with Lupton Street Studios on the studio website, in the media and social media outlets.

WAIT LIST FOR MUSIC LESSONS - type YES if you would like to be on the wait list for private music lessons.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs / Allergies / Medications (Leave blank if NONE)

Media Release 26-27*

Wait list for Music Lessons?

MEDIA RELEASE - type YES, or NO in the box above
I give consent for myself / my child(ren)'s name or photo or video to be used in association with Lupton Street Studios on the studio website, in the media and social media outlets.

WAIT LIST FOR MUSIC LESSONS - type YES if you would like to be on the wait list for private music lessons.

Enroll in Classes

Select Class

Registration

Family Information

Where do you live?

Contact #1

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Portal Access (your email is your login)

Student #1

Additional Info

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Student #2 (Show-Hide Details)

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Student #3 (Show-Hide Details)

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Student #4 (Show-Hide Details)

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Student #5 (Show-Hide Details)

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Required Policies

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Questions or Concerns

Registration

Family Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

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Student #4 (Show-Hide Details)

Additional Info

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Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

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