Teupha Week Registration

Teupha Week Registration | June 11-14

Student Name

Student Email

School Name

Musical Awards/Honors

Private Lesson Teacher (if applicable)

Band Director

Parent/Guardian Name (Primary Contact)

Parent/Guardian Email (Primary Contact)

Parent/Guardian Phone Number (Primary Contact)

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number

Pertinent Medical Info

Do you have any questions or comments?

I accept the terms & conditions of the Media Release Consent Form

I accept the terms & conditions of the Cancelation/Refund Policy

Select an item ($)

Teupha Week Registration - $275

Teupha Week Registration + Two 30 Minute Private Lessons - $335

Thanks for registering for Teupha Week. See you on June 11th!