Registration Form for Piano Lessons with Fiona

Please print, complete and return to Fiona via email. See contact details in the Terms and Conditions.

Pupil Name:

Date of birth:

Parent/Guardian email address:

Parent/guardian Phone no:

Home address and post code:

Please give details of any SEN, medical condition or other circumstance of which you would like me to be aware:

DECLARATION by Parent / Guardian: I confirm that the information given in this application is correct. I confirm that I have received, understood and agree to abide by the Terms & Conditions (Sept 2025).

Signed (parent/guardian):

Date: