BEST Piano Club Registration Form

*Notice. We respect your privacy and keep your information private.

Child's Name *

Age *

Parent(s) Name(s) *

Address *

Postal Code *

Area of Town *

(i.e., Barrhaven, Riverside, etc.)

Phone Number *

Email *

Does anyone in your house take piano lessons? *

Yes

No

If no, are you or your child planning to start piano lessons? *

Yes

No

Do you own a piano? *

Yes

No

If yes, what make is your piano

I understand someone will contact me to tell me about more exciting events, including free concerts

I understand someone will contact me to tell me about more exciting events, including free concerts

*

Send me a copy of my responses