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* 1. Please complete the following details:

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* 2. Please select the appropriate answer.

  Yes No
Is it suitable for us to email any written correspondence to you?
Do you agree for pictures of the student to be used in any Encore! publications and for marketing purposes? (for example, website, Facebook, newsletters)

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* 3. What classes would you like to sign up for? (Please skip to the next question for Encore! Tots or Encore! Kids Music Classes)

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* 4. Which Encore! Tots or Encore! Kids Music Classes would you like to sign up for?

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* 5. Please complete the following regarding lesson details:

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* 6. Please complete the following details about the student.

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* 7. If you are having lessons at Churton Park on Saturday, please indicate all the time slots that work for you. Please ignore this question otherwise.

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* 8. If you are having lessons at Johnsonville (Tuesdays) and Mt Victoria (Thursdays), please indicate all the time slots that work for you. Please ignore this question otherwise.

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* 9. Please provide contact details of an alternative contact person in the case of an emergency.

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* 10. Please tick to acknowledge that you agree to the terms and conditions stated on our website (under the 'Enrol Now' page): http://www.encoreschoolofmusic.co.nz/

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