Songwriting Workshop Registration Student Name* First Last Student's Age*Select Age89101112131415161718AdultParent/Guardian Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone Number*Email* May we use photographic images and sound bytes of your child for promotional material? Yes No How did you hear about this class? Mailing List Sign up for our mailing list to find out about new and upcoming classes No thanks. Class SelectionProduct NameSelect Your Songwriting Workshop*Select ClassSongwriting Ages 8-11Songwriting For Teens (12+)Songwriting for AdultsPayment InformationCredit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Security Code Cardholder Name TotalReview your total. By submitting this form you authorize the amount to be charged to your credit card.