Student/Performer Name *

First Name

Last Name

Instrument(s) of choice:

Piano

Voice

Guitar

Teacher's Name: *

Mr. Derek Hudson

Mr. Josh Evans

Mr. Ben Strom

Mr. Jacob Patrick

Mr. John King

Ms. Laura Cubi

Mr. Ethan Eckhard

Mr. Levi Garnder

Parent/Guardian Name *

First Name

Last Name

Phone *

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