ONLINE REGISTRATION

Child's Name *

Birthday *

Age *

Gender *

(1) Parent's Name *

Email *

Cell *

Work

Home

(2) Parent's Name

Cell

Work

Home

Address *

City *

State *

ZIP *

My child may be released to the following people:

Name

Phone

Name

Phone

Any relevant medical information (allergies, medications, etc.)

Explain any musical experience (instruments played, choir, etc)

Session Type

Little Sessions

Private Sessions

Group Sessions

Session Length

Payment Options Pay by credit card
I will mail in my payment (Registration is not complete until payment is received)

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To complete the online registration process, please submit your paymnent.

Make check payable to Sessions Songwriting and mail to:

Sessions Songwriting
1739 Berkeley St.
Ste. 101
Santa Monica, CA 90404

Thank you!

Please print and sign the policy form and fax to (310) 828-8903 or bring in on the first day of class.