2026 Summer Registration Form
Thank you for registering for lessons with Exit 1 Piano Lessons! The 2026 Summer lessons will take place from May 31st, 2026-August 1st, 2026. We will be closed for one week during the summer from June 28th-July 4th, 2026. You can sign up at any time during the summer. Our system can prorate your first month of lessons if you sign up in the middle of the month. You can choose between 30, 45, or 60 minute weekly lessons. Once you register, one of our office workers will reach out to help you schedule your weekly lesson time. Don't forget to fill out a separate form for each student and for each instrument! We look forward to seeing you soon!
Student Information
Student Name
*
First Name
Last Name
Student Age
*
Please Select
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Adult
Student Birthday
*
(MM/DD/YYYY)
Years of Experience
*
Please Select
0
1
2
3
4
5+
Is there anything else you would like the instructor to know about the student?
Lesson Type and Length
Choose your instrument and length of lessons. You can also indicate your instructor preference if desired.
For which instrument would you like to register?
*
Piano
Voice
Guitar
Violin
Percussion/Drums
Trumpet
Trombone
Cello
Composition/Music Theory
Flute
Clarinet
Saxophone
Please select your lesson length below:
*
30 Minutes
45 Minutes
60 Minutes
Preferred Instructor
Please Select
NO PREFERENCE
Marcel Stowe - piano
Gabriel Smith - piano
Alejandro Ochoa - percussion, piano
Ashantia Mitchell - guitar
Rene Villarreal - guitar
Ninfa Garcia - voice,flute
Toa Bouakham - voice
Zach Raphael - cello
Timothy Lewis - violin, piano
Mattie Smith - violin
Luke Kanzlemar - brass
Contact Information
Parent or Guardian Name (Adults put N/A):
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Media Release
*
I give my permission for mine or my child's likeness in images or videos to be used on the Exit 1 Piano Lesson website and social media page(s) or in advertisements.
I do NOT give my permission for mine or my child's likeness in images or videos to be used on the Exit 1 Piano Lesson website and social media page(s) or in advertisements.
By submitting your registration form, you are agreeing to abide by the Policies and Procedures found on our website: exit1pianolessons.com. Please check the box below to indicate that you have read and understand the Policies and Procedures.
*
I agree to abide by the Policies and Procedures during the Summer 2026 lessons.
Signature
Payment
Once you have a weekly lesson time scheduled, you will receive an invoice to pay for your fist month of lessons. If you begin lessons in the middle of the month, our system will prorate the first month's price for you. You will need to save a card on file when you pay the initial invoice, and you must pay the initial invoice before your first lesson can take place. Our monthly prices are as follows: Weekly 30 minute lessons - $125 per month, Weekly 45 minute lessons - $187.50 per month, Weekly 60 minute lessons - $250 per month. You only need to pay the $10 registration fee at the time of registration. The registration fee is non-refundable.
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