Student's Name:
Student's Age:
Parent's/Guardian's Name:
Parent's/Guardian's Name:
Home Phone:
Home Phone:
Mobile Phone:
Mobile Phone:
Address:
Address:
City:
City:
State:
State:
Zip:
Zip:
Email:
Email:
Siblings Name:
Siblings age:
Are any siblings enrolled in My Music Skool?
Please select a type of lesson
Private Lessons:
Group Lessons:
If Brass/Wind or String is selected, which one?:
Previous Lesson Information
1) Has student taken lessons before?
If yes, how long?
2) Does student have lesson material?
If yes, what?
3) Do they take music classes in school?
Which instrument?
4) Can they read music?
5) Do they have an instrument preference?
If yes, which?
Medical Information
Hospital/Clinic Preference:
Physician's Name:
Physician's Phone:
Allergies/Speical Health Concerns:
Releases & Consent
In case of emergency, I understand that every effort will be made to contact the persons indicated. In the event that indicated persons can not be contacted, I authorize the physical/hospital selected by the studio to secure all necessary treatments required for the safety and welfare of the student. I hereby agree to pay all expenses incurred by such an emergency. Including your name equals your signature.
Your Name:
I agree to pay for all lessons and materials provided by My Music Skool, Inc. by the first lesson of the month. I also agree to pay for any late charges or expenses incurred in the attempt to collect the unpaid lessons or materials.
Your Name:
Your student may be dropped off at his/her lesson five minutes prior and stay with us five minutes after the lesson. Please be on time so other students aren’t affected.
We appreciate any referral you can give us. In appreciation for the referrals, we’ll give you a FREE LESSON applied to the next month’s tuition (after referral’s enrollment).
If you have more than one student attending our school in your family, you may qualify for 10% discount starting your 2nd student. Please note that the discount is only valid for weekly lessons that are paid on time. If your tuition is not received by 1st week of each month, you must pay full tuition for all of your students in your family.
Tuition is due on the first day of each month. Please understand that we can not allow your student to take lessons unless payment has been made. After 1st week of each month, any unpaid balance will accrue a $10 late charge.
If we do not receive the tuition including the late charge by end of each month, your reserved spot will be open to other students.
Unless you let us know otherwise, we assume that each enrolled students return to their lesson on continuing basis each month.
Any returned checks will be charged $25.
If you have to miss a lesson, you must call us at least 4 hours in advance to cancel. If we receive your cancellation after the 4 hour window or if you do not show up for lessons without giving us the advance notice, you will be charged for the lesson and it will not be rescheduled.
You must fulfill lesson schedules as we initially set up with you. You must pay for all lessons on continuing basis and none of missed lessons will be credited towards future lessons.
There is no refund for lessons or registration fee for any circumstances.
We do not have a long term contract that requires you to stay with our school. However, you must finish up the month you started. We will not cancel a lesson in a middle of a month or refund any unused lessons.
You must provide us at least 4 weeks of prior notice before withdrawing your child so we can open the spot for other students.
If your student is sick, has a fever, or something that would effect the other student’s at My Music Skool, please keep them home until they are completely well or confirmed non-contagious.
We value the safety of our staff and students. At any time, if a student is believed to be too sick or a verbal or physical threat, a call will be made to any authorized person(s) to arrange an immediate pickup of the student.
For new students, a one time registration fee of $75.00 is due at the time the registration form is submitted.
We are always open for suggestions or comments and promise to keep all information confidential. Please send us an e-mail at admin@mymusicskool.com .
If you would like to have tuition taken out via credit card, please fill out the Credit Card information form. Tuition and book charges will be withdrawn on the 1st of the month.
I hereby agree to all studio policies and fees. Including your name equals your signature.
Your Name:
Please note that your lesson can not be scheduled unless you pay the registration fee and the 1st month of lesson. You can come in to our school to make the payment or pay over the phone with your credit card when we call to confirm your registration.
