Virtuoso School of Music and Art Registration Form

Welcome to Virtuoso School of Music and Art. Registration Form

Register student to our Virtuoso School from below
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
1 Parent Name

First NameLast Name
2 Parent Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
Email
example@example.com
Emergency Contact

First NameLast Name
Relation to the Student
Phone Number

Area CodePhone Number
How did you hear about us?
Disabilities/Special Needs
N/A or Provide information
1 Student Name

First NameLast Name
2 Student Name

First NameLast Name
3 Student Name

First NameLast Name
1 Birth Date

MonthDayYear
2 Birth Date

MonthDayYear
3 Birth Date

MonthDayYear
1 Choice of Instrument
2 Choice of Instrument
3 Choice of Instrument
Pick Days for Classes

Other
Length of Lesson
Time of lesson

:HourMinutesAM/PM Option
Time of lesson

:HourMinutesAM/PM Option
Time of lesson

:HourMinutesAM/PM Option
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Choose a Package for Music Lessons
Comments
Welcome Latter
Read and Confirm your understanding and agreement to the following company policies below
Media Release and Photo Consent. We love sharing your child’s talent with you by taking photos and videos of individual and group activities and providing those to our parents and social media pages. Please complete this consent form in order to allow your child to be photographed during classes and special events organized by Virtuoso School of Music and Art. If you do not want to have your child photographed or recorded, please indicate this in the section below.
Name

First NameLast Name
Signature
Action Required:Set Up Automatic Tuition Payments!

To enroll in automatic tuition payments, please call our office(980-244-3113) and provide your credit or debit card information! Please note that maintaining an active payment method and copmleting the automatic payment setup is the client's responsibility. Once your account is set up, tuition will be processed automatically according to your monthly or package enrollment schedule.Automatic payments help prevent missed or late payments and allow us to keep your student’s lesson time reserved without interruption. Please contact our office at your earliest convenience to complete the enrollment process.
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Welcome to Virtuoso School of Music and Art. Registration Form

Action Required:Set Up Automatic Tuition Payments!