2022-2023

Registration Form

2022-2023 Studio Policies

Student Information

Student's Full Name

First Name

Last Name

Age

Grade

Birthday

Parent/Guardian Info

Parent/Guardian Full Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone

(###)

###

####

Secondary Phone

(###)

###

####

Plans of Study

Mr. Kline (As Scheduled)

One-Weekly 45 Minute Private Lesson

One-Weekly 60 Minute Private Lesson

Preferred Payment Method

Agreement

I, (Parent/Guardian Name)

First Name

Last Name

, the parent/guardian of

(Student Name)

First Name

Last Name

Have read and understand the printed policies of Now Embodied Sound Studio and agree to enroll the student listed above in piano lessons from August 2022 to July 2023. I agree to pay the annual amount listed above, and I further agree that should I withdraw my child from piano during this period, I remain responsible for the full annual tuition.

Digital Signature

First Name

Last Name

Today's Date

YYYY