Student Name *
Student Name
Emergency Contact Name 1 *
Emergency Contact Name 1
Emergency Contact Phone 1 *
Emergency Contact Phone 1
Emergency Contact Name 2 *
Emergency Contact Name 2
Emergency Contact Phone 2 *
Emergency Contact Phone 2
Emergency Contact Name 3 *
Emergency Contact Name 3
Emergency Contact Phone 3 *
Emergency Contact Phone 3
Is the student a ukulele beginner, or does the student have prior uke experience (know at least 4 chords)?
Checkbox *
Required *
Digital Signature *
Digital Signature
Type your name