Registration
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Welcome to Red School of Music! Please complete the following registration form to sign up for lessons or classes. Upon completion, you will be directed to the parent portal to make lesson selections and your payment. Making payment completes the process and confirms your enrollment.
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Referral Information
How did you hear about us?
Coupon
Exhibition
Facebook
Instagram
Internet Search
Other
Parents Magazine
Performance
Referral
Returning Family
Walk-In
Website
Referral Name
Family Information
Family Last Name
*
Where do you live?
Home 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
PR
VI
Zip
*
Primary Phone
*
Contact #1
Contact #1 First Name
*
Last Name
*
Type
*
Caregiver
Father
Grandfather
Grandmother
Guardian
Mother
Other
Parent
Self
How Can We Contact You?
Home Phone
Work #
Cell #
*
Portal Access (your email is your login)
Email
*
(Emails are kept confidential)
Confirm Email
*
Portal Account Password
Confirm Portal Account Password
Contact #2
Contact #2 First Name
Last Name
Type
Caregiver
Father
Grandfather
Grandmother
Guardian
Mother
Other
Parent
Self
How can we contact you?
Home Phone
Work #
Cell #
Email
(Emails are kept confidential)
Confirm Email
Student #1
Student's First Name
*
Last Name
*
Student Gender
Female
Male
Other
Birth Date
*
(format=mm/dd/yyyy)
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Schedule preferences:
Instrument/Lesson Type:
Previous experience/training
*
Student #2
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
Female
Male
Other
Birth Date
*
(format=mm/dd/yyyy)
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Schedule preferences:
Instrument/Lesson Type:
Previous experience/training
*
Student #3
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
Female
Male
Other
Birth Date
*
(format=mm/dd/yyyy)
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Schedule preferences:
Instrument/Lesson Type:
Previous experience/training
*
Student #4
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
Female
Male
Other
Birth Date
*
(format=mm/dd/yyyy)
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Schedule preferences:
Instrument/Lesson Type:
Previous experience/training
*
Student #5
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
Female
Male
Other
Birth Date
*
(format=mm/dd/yyyy)
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Schedule preferences:
Instrument/Lesson Type:
Previous experience/training
*
Add Another Student
Required Policies
(Show-Hide Details)
I Agree to All of the Above
Enter your Full Name
*
Questions or Concerns
Comments
Payment Information
Please fill out CREDIT CARD Payment Method
Credit Card
Card Number
*
Visa
Mastercard
Exp Month
*
01
02
03
04
05
06
07
08
09
10
11
12
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
*
eCheck/Bank Draft
Bank Name
Account Type
Checking
Savings
Your Account Name
(Your name on your bank statement)
Bank Routing Number
(9-digit number)
Account Number
