Beginner Piano Class
Fridays 11:20-12:20pm

Little Orange Academy After-School Music Class Registration Form

Please note that all fields followed by an asterisk must be filled in.

First Name*

Last Name*

E-Mail Address*

Street Address*

City*

Home Phone*

Student's Name*

Age*

Music Class *

Do you need to purchase an instrument through OPMI?*

Where will your student go after their music class*

Do you authorize OPMI to use photos of your child on our website and/or promotional material?*

OPMI Terms and Conditions*

I have read and agree to the OPMI Terms and Conditions regarding payments, cancellations, instrument requirements and child pick-up and I wish to register my child for this class.

Special Requests/Needs/Concerns:

Beginner Piano ClassFridays 11:20-12:20pm

Little Orange Academy After-School Music Class Registration Form

Beginner Piano Class
Fridays 11:20-12:20pm