Student's Name
Parents' name(s) if student is under 18
Address
City
Zip Code
Phone numbers (use numbers only & no dashes or parenthesis or you will get an error message)
Email address
Student's Age
Skill Level/Experience
Goals
Private Lesson or Class Format (Please check one)
Time and Day Preferences for lesson/class
Best time to reach you / which number
I will not hold Tony K. Johnson at fault for any injury that may occur during or after this lesson/course. I also understand that Tony Johnson will protect my e-mail information and use it only for his tool for communication. (If you agree, type "Yes" in the box)
We require that full payment is made in advance before we come out to teach you.
