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*

MondayTuesdayWednesdayThursdayFridaySaturdaySundayOther
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
Payment/Collection method.

Dear Valued Customers, We want to assure you that your trust and security are paramount to us. As part of our commitment to safeguarding your financial information, we offer the option to securely store your credit and debit card details on file for convenient future transactions. Please rest assured that your card information is encrypted and stored in compliance with the highest industry standards. We adhere strictly to data protection laws and regulations, ensuring that your information is never sold or shared with any third parties for marketing or other purposes.
Credit Card Authorization Form.*
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.*
Release of Liability Waiver Consent Form *
Name*

First NameLast Name
Signature*

Clear
Should be Empty:

Welcome to Virtuoso School of Music and Art. Registration Form

Payment/Collection method.