Registration Form

Please fill out this registration form at least three days prior to your initial lesson.  Required for new students only.

All fields required except the "Comments" section.

Date:
Parent's full name:
Found us how?
Referred by?
Drum set in home?
Non-smoking home?

Information below applies to student only

Contact e-mail:
Student's age:
Student's school:
Student's gender:
Student's full name:
Home address:
City, State, Zip:
Home phone:
Cell phone:
Work phone:
Teacher:
Tuition rate:
Starting week:
Starting month:
Available from:
Available to:
On days:
Check number:
Total amount:
Tuition sent how?
I understand that the tuition must be received at least three days in advance of each single lesson or monthly program.
I agree with the enrollment policies.  
Comments:
...................................  
If you haven't already contacted In Home Drum Lessons to discuss the day and time for your lesson, a representative will contact you after receiving this form.  Thank you.

No person shall be discriminated against in any term, condition, or privilege because of race, creed, color, gender, sexual orientation, marital status, religion, national origin, ancestry, age, mental or physical disability.  In Home Drum Lessons does not discriminate in the administration of its educational policies, admissions policies and educational programs and activities.

Call for more information
(303) 402-1500
Boulder Drum Studio - Boulder, CO
Mailing Address
Boulder Drum Studio
1320 Pearl Street, #107
Boulder, CO 80302