Student Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Name *

First Name

Last Name

Parent Phone *

(###)

###

####

Parent Name

First Name

Last Name

Parent Phone

(###)

###

####

Social Media Permissions *

I authorize JKW Music Studio to utilize photos and videos of my child/student for social media purposes.

Yes

No

Lesson Permissions *

Proper posture and special breathing techniques associated with singing is important. A practical application to assess or demonstrate the above may require the instructor placing their hands on the students back, under the ribs on the upper abdomen, neck or jaw. On occasion a student may be asked to place their hands on their instructors back, ribs, neck or jaw if further practical application is required. Please check the box if you consent to this practice.

Yes

No

Payment Schedule *

Annual Payment

Bi-Annual Payment

Quarterly Payment

Monthly Payment (has increased admin fees)

Preferred Voice Instructor

Teachers & availability subject to change. Please feel free to select more than one, as it may help with scheduling!

Jessica Kos-Whicher

Karen Santos

Jacqueline Arthur

Hailey Witt

Sofia Escamillia

Sonia Campbell

I am okay with anyone!