Registration Student's Name Parent's Name Student's Date of Birth Address City Postal Code Phone (cell #) Phone (home #) Emergency Contact Name Emergency Contact Phone Email Address PianoVocalTheory Lesson Type: Desired day & time of lesson: How long has student played piano / been singing? Is this your (child’s) first time in piano/ vocal lessons? If not, how many years? What do you hope to accomplish through lessons this year? Are you interested in performing in recitals? Are you interested in doing RCM (Royal Conservatory of Music) exams? (only applicable to piano lessons) Are there any medical concerns you would like me to be aware of? Will any other friends or family members be doing the drop off/ pick up? (please inform me of any individuals who are not supposed to be picking up your child) If you have trouble with this form, please email: sikorastudios@hotmail.com