Chris Imhoff

Sign Up Form

Sign Up Form

Please fill out the form below.

Welcome

Please complete the sign up form below and I will get back with you as soon as possible.

Student

First Name *

Last Name *

Student Email

Student Phone

Contacts

Primary Contact First Name *

Primary Contact Last Name *

Primary Contact Email*

Primary Contact Phone Number*

Secondary Contact First Name

Secondary Contact Last Name

Secondary Contact Email

Secondary Contact Phone Number

Additional Questions

School *

Current Grade *

Name of Band Teacher *

Lesson Day Preferences *

I agree to receive transactional SMS lesson reminders at the phone number(s) provided.

This checkbox is optional and is not required to submit the form. Message and data rates may apply. Message frequency varies based on scheduled lessons. Messages are only sent as lesson reminders. Reply STOP to opt out. No promotional or marketing text messages will be sent through this consent.

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