Galina's Guitar Studio - Registration

Registration

Are you an adult student or the parent of a student?

I am a(n)

Adult Student Information

First name *

Last name *

Email *

Phone *

Alternate Phone

Birthday (example: mm/dd/yyyy) *

School *

Street *

City *

State/Province *

Zip/Postal Code *

Country *

Login Details

Username *

Password *

Verify Password *

*You will not be able to login until your teacher has activated your account.

Parent Information

First name *

Last name *

Email *

Phone *

Alternate Phone

Street *

City *

State/Province *

Zip/Postal Code *

Country *

Login Details

Username *

Password *

Verify Password *

*You will not be able to login until your teacher has activated your account.

Student Information

First name *

Last name *

Phone

Birthday (example: mm/dd/yyyy) *

School *

Login Details

Username

Password

Verify Password

Additional Information

Is there any special information you would like the teacher to know?

Which days of the week you cannot have a lesson?

Can you be flexible with your lesson day/time? Would you like to be on the list of parents who can exchange the day/time of the lessons with you in case of emergency?

By checking the box and clicking 'Register" you agree to our studio policy.