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
Date
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*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Length of Lesson*

30 Minutes45 Minutes60 Minutes2 Hours3 Hours
Time of lesson *

:HourMinutesAM/PM Option
Time of lesson

:HourMinutesAM/PM Option
Time of lesson

:HourMinutesAM/PM Option
Start Date*

MonthDayYear
Date
Choose a Package for Music Lessons *
Comments
Please provide Skype Username
Credit Card Authorization Form *
Welcome Latter *
Read and Confirm your understanding and agreement to the following company policies below .

_________ I have read the welcome letter, which outlines the rules of the school and I agree to follow these rules and policies.

_________ I understand that it is my responsibility to pay ahead of class sessions in order to attend class.

_________ I understand that when I use automatic payment for recurring monthly payments that I must provide updated information to the school if my payment method should change. Declined payments accrue late fees, which I must pay in addition to my monthly payment to attend class.

_________ I understand that I must provide 30 days written notice using the school’s withdrawal from, which must be returned to the Director of the school to end my automatic payments and withdrawal from school.

_________ I understand that failure to provide written notice will cause my classes to be continued and my card will be charged the amount of the program. These time slots are reserved for the student and providing notice of withdrawal 30 days in advance allows the school to fill the now open spot.

_________ I understand that the teachers are present for class even if I miss and therefore missing a class will not result in a refund. The school offers the opportunity to reschedule missed classes if prior notice of at least 24 hours is provided. All rescheduling must be approved by the administration, not the
teacher alone.

_________ I understand that there are no make-up lessons for group Music, Art, or Dance classes.

_________ I understand that the school reserves the right to provide a substitute instructor if the regularly scheduled instructor is unable to attend a lesson. If the school cannot arrange a substitute, any missed lessons will be rescheduled for make-up. The school reserves the right to replace an instructor with a new qualified instructor in the event an instructor is no longer with the school, no longer available at a student's desired lesson time, or for any other reason.

_________ I agree that parents must pick up their child promptly after his/her class. If a parent is late due to traffic or any other emergency, they must inform the office immediately to avoid the $10
late pick-up fee.

I understand that The Virtuoso School of Music and Art may make changes to these policies and procedures at their discretion. By signing below, I agree to these terms and feel excited to grow my
personal talent or my child’s talent in the arts.
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.*
Release of Liability Waiver / Consent Form

I, the undersigned, as the parent or legal guardian of do hereby give my full consent and approval for my child to participate in activities at the Virtuoso School of Music and Art.

I understand that there are certain risks of play that may result in damages and injuries in the participation of my child during these activities and I hereby accept these risks on behalf of my child.

I hereby certify, outside of listed restrictions I have noted below, that my child is fully capable of participating in dance, yoga, and theater activities and that my child is healthy and has no hidden physical or mental disabilities or infirmities that would restrict his/her full participation in such activities. Please let us know at the comments section all restrictions that may affect your child’s physical participation that we should be aware of.

I hereby, for myself and on behalf of my child agree to hold harmless and fully indemnify the Virtuoso School of Music and Art management and staff, on the account that all normal safety procedures have been taken on behalf of management and staff, from any and all liability for any personal injury or injury to any third-party child resulting from my child’s actions/participation in the above-mentioned activities.

I hereby release Virtuoso School of Music and Art and its entire staff from all liability, on the account that all normal safety procedures have been taken on behalf of management and staff, for any injuries that my child may sustain as a result of any activities taken place at the Virtuoso School of Music and Art.

Further, I consent to my child receiving medical care appropriately needed from Virtuoso School of Music and Art and for the paramedics to be contacted should a medical emergency occur. Should medical care be needed, I consent to bare the cost of such {signature}medical care and treatment needed for the protection of my child.
Name*

First NameLast Name
Signature*

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Welcome to Virtuoso School of Music and Art. Registration Form