The Music Place
TRIAL GROUP CLASS REQUEST FORM
You may use this form to request a free trial group class, PLEASE NOTE: Classes listed as "JOIN THE FORMING LIST" are not available. Session classes (i.e. Instrument Prep) require a trial class fee.
Student & Family Information
Class & Schedule Information
Please give information for the student needing options
Student First & Last Name
Date of Birth
Does this child need special attention or have special needs?
Please explain your child's needs or diagnosis:
Has this family been enrolled at The Music Place previously?
NO, our family is new to the Music Place
YES, our family has been enrolled previously
Voucher or Coupon Code?
Parent Contact Information
Mom First Name
Mom Last Name
Dad First Name
Dad Last Name
Best Phone Number
Whose phone # is this?
Address or Nearest Cross Streets
Do Not Fill This Out