Student Name *

First Name

Last Name

Phone/Cell Number *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student Date of Birth *

MM

DD

YYYY

Instrument *

Piano

Voice

Guitar

Ukulele

Bass guitar

Saxophone

Theory

Drums (in home only)

Violin

Clarinet

Lesson Location *

Studio Lessons

In-Home Lessons

Online Lessons

Bedson School (only for students who attend there)

Lesson Length *

15 Minutes (For younger siblings)

30 Minutes

45 Minutes

60 Minutes

Semester *

Please Select All That Apply

Spring (April-June 2025)

Summer (July- August 2025)

I have read and agree to the Polices of Labdon Studios *

I agree

Photo Release Form *

I give permission to Labdon Studios to take video recordings and digital photographs of me or my child to use as promotional material for the studio. I authorize Labdon Studios to use my child’s image on its websites and/or social media accounts without further consideration and I acknowledge Labdon Studios’ right to treat the media at its discretion.

Yes

No