Student Name *

First Name

Last Name

Student Phone

(###)

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Parent Name *

First Name

Last Name

Parent Phone *

(###)

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Please indicate your availability *

Student and a parent must attend together. We will need about 20-30 minutes to get acquainted and walk you through the studio. Mark all that apply.

Weekdays between 3 and 5pm

Weekday evenings between 5 and 7pm

Weekends between 11 and 1pm