Central Iowa Flute Workshop

Student Center, Grand View University, Des Moines

First Name

Last Name

Mailing Address

City / State / Zip

Name of School

Private Teacher's Name

Current Grade / Experience Level

Would you like to participate in playing in a master class?

Yes

By checking this box, I give permission to Grand View University and affiliates to use images containing above participant for promotional usage.

Yes, I give permission.

By checking this box, I accept Grand View University's waiver of liability.

Yes, I agree.

Please list any dietary restrictions or allergies, if any.

Number of registrants

1 student - $35.00