Name *

First Name

Last Name

Phone Number *

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# of students (Participants are required to source students for their small group class)

2

3

4

Age range of students *

3 - 7 years old (Music & Movement)

8 to 15 years old (Music & Movement or Song Performance)

16 to 21 years old

21 year+

Experience level of students *

Beginner

Intermediate

Advanced

Area of Interest *

Song Performance

Songwriting

Music & Movement

Music Theory Basics