Piano Registration - Lakehead Festival of Music and the Arts

Student Information

*Student One Name

Address

City

Postal Code

*Date of Birth (YYYY/MM/DD)

*Student One Email

*Phone

*Student Two Name

Address

City

Postal Code

*Date of Birth (YYYY/MM/DD)

*Student Two Email

*Phone

*Student Three Name

Address

City

Postal Code

*Date of Birth (YYYY/MM/DD)

*Student Three Email

*Phone

Teacher Information

*Teacher Name

*Teachers Email

*Phone

*Number of Classes PLEASE SELECT FROM THE DROPDOWN

*Indicate Grade or Age Level

Music Information

Music Selection

Length (min)

Music Selection

Length (min)

Music Selection

Length (min)

Music Selection

Length (min)

Music Selection

Length (min)

Music Selection

Length (min)

Payment Information

Please pay the amount displayed in the "Total" Payments to be made as Interac e-Transfer to dmsebesta@gmail.com (no password required) or cheque payable to "Lakehead Music Festival"

TOTAL $ 0

Code of Conduct

Please read and review the LFMA Code of Conduct.

CLICK HERE TO VIEW THE LFMA CODE OF CONDUCT

*Do you agree with the Code of Conduct

I Agree

Notes:

Student Information

Teacher Information

Class Information

Music Information

Payment Information

TOTAL $ 0

Code of Conduct