Zoom – Simon Harper Music

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Parent / Guardian / Carer Details
Name*
First Last
Email*
Phone*
Child Details
Child Name*
First Last
Instrument*
- Guitar
- Keyboard
- Piano
Lesson Type*
- Group (£6 per half hour session)
- Individual (£10 per 20 minute session)
Consent*
I consent to the above information being passed to Simon Harper
The information given will be passed to Simon Harper and only used in connection with providing video music tutorials for your child.

Parent / Guardian / Carer Details