Form for Existing Students

This form is for existing students of Rosangel's Piano Studio. Feel free to explore the website and see if there is anything else you are interested in! :)

-Rosy

Piano Lessons with Rosangel

Student 1 Full Name

Student 1's Birthdate

Student 2 Full Name

Student 2's Birthdate

Student 3 Full Name

Student 3's Birthdate

Guardian's Full Name. If under 18. (First, Last)

Student's Email/ Parent's Email if Under 18

Cell Phone Number

Home Address

Student's Academic School. If homeschooled, please type "Homeschool"

Preferred Language

Sessions you are interested in. Please list all that apply. For more information regarding Music Therapy, visit our "Music Therapy" page.

Music Therapy

Voice

Piano

Guitar

Ukulele

Cello

Trumpet

Trombone

Drum Set/Percussion/Timpani

Lesson Length- Student 1 *

30 minutes - $32.50

45 minutes - $48.75

1 hour - $ 65

Lesson Length- Student 2

30 minutes - $32.50

45 minutes - $48.75

1 hour - $ 65

Lesson Length- Student 3

30 minutes - $32.50

45 minutes - $48.75

1 hour - $ 65

How did you hear about us?

Terms & Conditions Agreement*

I have read and agree to the terms & conditions established by Miami House of Creative Arts LLC.View terms & conditions

Media Release Consent Form*

I authorize the following (select one of the options below) regarding the capture of my own/my child's musical performances and images, which will be used for educational and promotional purposes only. *

A photo or video of me/my child with name attached

A photo or video of me/my child with no name attached

Only group pictures with no name attached

None of the above

Signature

Thanks for submitting! We will contact you shortly to schedule your first lesson!