Official Registration Form

Please complete the form below. Thank you!

Student Name # 1 *
Student Name # 1
Gender *
Birth Date *
Birth Date
Student Name # 2 (if needed)
Student Name # 2 (if needed)
Birth Date
Birth Date
Primary Contact Info
Name *
Address *
Mobile Phone *
Mobile Phone
Did you visit or take lessons at another music school? *
PLEASE READ CAREFULLY - Agreements and Policies
Monthly Auto-Payment Agreement *
Monthly payments are made through our easy, automatic payment system. Payments can be made by credit card, debit card, or ACH. Payments are made on the same date each month and you can cancel anytime. Every 3rd month the student will have a 5th lesson. Students will be automatically billed for the 5th lesson at the time of the lesson.
Missed and Make-Up Lessons Agreement *
If you must miss your lesson, please notify us at least 2 days prior to your lesson. If more than 2 days notice is provided, you may reschedule as needed. If less than 2 days notice is provided, it is considered a late cancellation and no makeup lesson will be given.
Withdrawal and Refunds Agreement *
There is a 1 month minimum for all lessons. 30 days notice is required to discontinue any classes. To withdraw from lessons, a parent or adult student must complete and sign the studio’s withdrawal form.
Policies and Procedures *
Extreme Weather or Unexpected Interruption of Lessons: If the studio must cancel lessons due to extreme weather or events beyond our control such as power outages, the missed lessons will be made up. The studio will be open unless you are notified otherwise, even on school snow days. No refunds for lessons missed due to other reasons will be given. Substitutions: The studio reserves the right to provide a substitute teacher if the regularly scheduled teacher is ill or otherwise unable to attend a lesson. If a teacher is ill and the studio cannot arrange a substitute any missed lessons will be made up during openings in the teacher’s schedule in the coming weeks or with other teachers. Parent’s Responsibility to be Aware of Dates and Events: It is the responsibility of the parent or adult student to be aware of studio activities such as recitals and dates the studio is open and closed. The studio will send notices home with the students regarding these important dates. It is also the responsibility of the parent or adult student to inform the studio of any address or telephone number change. Injuries: Parents, legal guardians of minor students and adult students waive the right to any legal action for any injury sustained on studio property resulting from normal lesson activity or any other activity conducted by the students before, during or after lesson time. Photo Release: The studio is hereby granted permission to take photographs of the students to use in brochures, websites, posters, advertisements and other promotional materials the studio creates. Permission is also hereby granted for the studio to copyright such photographs in its name.
Electronic Signature *
Electronic Signature
Today's Date *
Today's Date