Little Wing Enrollment Form

Parent's Name* 

E-mail* 

Phone* 

Mailing Address* 

City* 

State* 

Zip Code* 

Child's Full Name* 

Child's Birthdate* 
MM/DD/YYYY
Child's Gender* 
Select A Session (All Sessions are 8 Weeks)

Session Price: $180

A $30 One-Time Registration Fee Required includes T-Shirt and Gig Bag

 

Payment Method 
Credit Card #* 

CVC Code* 

Expiration Month* 

Expiration Year* 

How did you hear about us?* 

Please enter name of parent who referred you 

 
Electronic Signature

I have read and agreed to the tuition, and cancellation policy of the School of Rock Little Wing Program. I give permission for publication of photographs, videos and recordings of my child at Little Wing. By enrolling in the program I understand that I will sign General Liability Waivers at my first class.

 

 

 

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