Voice Instruction – REGISTRATION

*Waiver Form (please read and sign below)

*Please view YPAC808 Policies before registering.

Student First Name(required)

Student Last Name(required)

Student Age(required)

Student Birthday(required)

Grade (if still attending school)

School name (if still attending school)

Student Email - if applicable

Student Mobile Phone - if applicable

Parent/Guardian First Name (if 18 or below)

Parent/Guardian Last Name (if 18 or below)

Parent/Guardian Email (if 18 or below)

Home Address(required)

Home Phone (if applicable)

Parent/Guardian Mobile Phone (if 18 or below)

Preferred Location (24-7, Metro or Kapolei)(required)

Preferred Lessons Day (Mon, Tues, Wed, Thurs or Sat)(required)

Preferred Lesson Time (morning, early afternoon, late afternoon or early evening) *please list specific time(s) if available(required)

Emergency Contact Info. - Name, Relationship & Phone no.(required)

Additional Comments

Medicine or Food Allergies? (Please list)

*after pressing Submit, “message sent” will appear, along with a review of your answers.
If not, please check all required areas carefully and submit again. If any problems, please contact Dane Ison (YPAC808 Director) at ypac808@gmail.com

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