Students Name:

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Female

Age

Parents Name (if student is a minor):

Address:

City:    State:     Zip Code:

Email:

Phone Numbers:

Home:   Cellular:

Work: (Check main contact number)

Enrollment Information

Instrument or Discipline (i.e.acting/dance)?:

Instructor Preference:

Prefrerred Days & Times:

Is Student a Beginner? Yes No

If no, explain student's experience

Is the student part of a band, orchestra or performing ensemble Yes No

To help us effectively place the student with an instructor list the musical genres or theater, dance styles the student is interested in:

In signing this form, I certify that all information provided is complete and true.

Signature:                     Date:


Printed Name:

Ethnic background (optional):
White    Black     Hispanic     Native American   Asian     other:

Before submitting this form, CLICK HERE AND PAY for lesson or lesson package (plus $25 annual SoBe Arts Annual Membership Fee, if you have not done so within the last 12 months). If you prefer not to use our online payment system you may pay in person at the office or mail this registration with check for payment to: SoBe Institute of the Arts. 2100 Washington Avenue. Miami Beach, Fl. 33139. Important note: Private Lesson payments and membership fee are non-refundable (no exceptions). Paid lessons are good for one year from date of purchase. After making payment return to this form, make sure all applicable sections are completed, then press submit button below.