Enrollment Packet (Digital Form)

Please read all policies contained in this packet first, we would recommend saving it or printing it, and then, fill out the following form.

Student or Client Name *
Parent or Guardian Name (if student/client is under 18)
Phone *
Emergency Contact Phone
Do you text message?
Email *
Student or Client Birthday
Mailing Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
What is your preferred method of contact?
Enrolling in Private lessons, Piano Lab, MT, etc.
Photo Release
From time to time, we may have a photographer friend of the academy, or one of us (the faculty) take pictures during a class, rehearsal, or presentation. If your child is in one of the photos, is it acceptable that we might use that on our website or Facebook page to show what’s going on at the academy?YesWe would rather you not (we won't post pictures with your child in them)
Child's Name
Signature Your full name here constitutes your signature on this form.
Acknowledgement of Late Policy *
Acknowledgement of Late Policy (Refer back to page 9 if need be) I have read and understand the late policy and know that if I do not pay tuition by the 10th of the month a $20 late fee will be applied. And that failure to pay tuition or late fees may mean disenrollment and a loss of my spot.I acknowledge and accept this policy