Your Name

Your Email

Name of Student   Gender:  Male Female

Grade Level (if applicable)

Name(s) of Parent/Guardian

Student Email

Student Cell Phone #

Parent/Guardian Email

Parent/Guardian Phone #

Parent/Guardian Work Phone #

Emergency Contact Name

Emergency Contact Phone #

Street Address

City, State, Zip

Medical Plan/Insurance #

Please describe any medical conditions:

How did you hear about HRA?

Friends that might like HRA Studios...

What times are you most available?
Mondays  4:00pm-6:00pm 6:00pm-8:00pm none
Tuesdays  4:00pm-6:00pm 6:00pm-8:00pm none
Wednesdays  4:00pm-6:00pm 6:00pm-8:00pm none
Thursdays  4:00pm-6:00pm 6:00pm-8:00pm none
Fridays  4:00pm-6:00pm 6:00pm-8:00pm none
Saturdays  4:00pm-6:00pm 6:00pm-8:00pm none

Does the student want to sing?  yes no

What instrument(s) will the student play?
 guitar bass keyboard drums horn other

Will you be joining a band with other friends? Please list them:

Does the band already have a name? What is it?

What is your style of music

Who are your favorite bands? Please list them:

What level is the student?
 rare (just starting) medium (getting the hang of it) well done (all set to take over the world)

Do you have your required instrument/equipment?  yes no

Does the student want to learn filmmaking?  yes no

Does the student want to learn music production?  yes no

Do you have other hobbies/talents you would like to explore at HRA?
Please list them: