Music Lover's Student Registration Form

Music Lover's Student Registration Form
Date*

MonthDayYear
Date
Name of Student*

First NameLast Name
Birthdate*

MonthDayYear
Date
Best Contact Number*
Please enter a valid phone number.
Preferred Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a parent or guardian registering a minor under the age of 18?*

Yes (continue to Section 1)No (skip to section 2)
SECTION 1

Parent Contact and School Information
Child's Name

First NameLast Name
School:
Grade:
Parent 1 Name

First NameLast Name
Cell Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Email
example@example.com
Parent 2 Name (if applicable)

First NameLast Name
Cell Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Email:
example@example.com
SECTION 2

Emergency Contact and Health Information
Emergency Contact*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Do you have any food allergies? *
If yes, please list them here: *
Do you have any other health conditions we should know about? *
If yes, please list them here: *
SECTION 3

General Registration and Music Background Information
How did you hear about Music Lover's*

ReferralDrive ByInternet SearchSocial MediaLessons.comOther
Do you have formal or informal experience singing or playing a musical instrument?*

YesNo
If yes, what instrument (including voice)do you play?blanks
Have you had music lessons before?*

YesNo
If yes, how long did you take lessons? blanks years blank months.
Desired Start Date:*

MonthDayYear
Date
Instrument or Class Subject*

VoiceSongwritingAcoustic GuitarBass GuitarElectric GuitarDrum SetCongas/Afro Cuban PercussionCajonViolinViolaCelloLittle Maestros Group Piano (ages 6-7)Multi Level Group Piano (ages 8-14)Piano (Adults only)
Lesson Day*

MondayTuesdayWednesdayThursdayFridaySaturday
Lesson Time*

Hour Minutes

AM/PM Option
Lesson Duration*

30 minutes45 minutes60 minutes
SECTION 4

Music Lover's Policies Acknowledgement Agreement and Signature
GENERAL STUDIO POLICY AND EXPECTATIONS

Students who are ill or are not feeling well should stay home and contact their instructor for available virtual options as soon as possible. If you stayed home from school or work, you are too ill to come to the studio.

If students or instructors begins to sneeze, cough, or have a runny nose while at the studio, masks will be required for the duration of the lesson.

Please be respectful of the Music Lover's waiting area. No food or drinks are allowed with the exception of water.

Parents are responsible for the supervision of their children and guests while on the premises of Music Lover's.

Parents are held responsible for any injuries to their children and guests under their watch and for any damages to the property or equipment at Music Lover's.

Parents, legal guardians of minor students and adult students waive the right to any legal action for any injury sustained on school property resulting from normal activity or any other activity conducted by the students before, during, or after class time.

Neither Music Lover's or its instructors provide before or after class supervision for students. Students should not arrive more than 5 minutes prior to the start of their lesson and should leave or be picked up promptly as soon as the lesson has ended.

INCLEMENT WEATHER POLICY

If local school districts are closed due to inclement weather, Music Lover’s Learning Center will also be closed. Check your email for updated studio information.

PHOTOGRAPHS, VIDEOS, AND SOCIAL MEDIA MARKETING

We will use pictures and videos of students participating in various Music Lover’s Learning Center activities to promote the studio. If you do not wish for your child to appear on the studio website or social media, you must indicate so on the studio media release form.

PRICING, TUITION, ATTENDANCE, AND CANCELATION POLICIES

Music Lovers has specific policies for pricing, tuition, and attendance for each instructor.

Instructor Studio Polices are available on the MUSIC LOVER'S STUDIO GOOGLE SITE and the instructor will provide a written copy of the policy at the parent or student's request.

If the student decides to discontinue private or group lessons, Music Lover's and the teacher must be informed at least 30 days in advance. Music Lover's will not refund any tuition or registration fee.
I HAVE READ AND UNDERSTAND THE MUSIC LOVER'S GENERAL STUDIO POLICY AND EXPECTATIONS AS WELL AS THE STUDIO POLICIES FOR THE INDIVIDUAL INSTRUCTORS ON THE MUSIC LOVER'S STUDIO GOOGLE SITE .

I AGREE TO ABIDE BY THE POLICIES THAT ARE OUTLINED IN THE ABOVE SECTION AND ON THE MUSIC LOVER'S STUDIO GOOGLE SITE FOR ANY OF THE INDIVIDUAL STUDIOS THAT I AM A PART OF.

THIS ALSO INCLUDES BUT IS NOT LIMITED TO REGISTRATION, LATE FEES, ATTENDANCE POLICIES, AND THE REQUIRED 30 DAY NOTICE TO TERMINATE LESSONS WITHOUT REFUND OF TUITION OR REGISTRATION FEE.

I ALSO UNDERSTAND THAT MY REGISTRATION IS NOT COMPLETE WITHOUT THE MEDIA RELEASE FORM AND STUDIO POLICY FORM ON FILE IN SECTION 5 BELOW, AND THAT IF I NEED TO CHANGE THE STATUS OF THE MEDIA RELEASE FORM I AM RESPONSIBLE FOR CONTACTING MY INSTRUCTOR TO UPDATE MY FORM.
Signature of Parent or Adult Student *

Clear
Date*

MonthDayYear
Date
SECTION 5

Media Release Form for Internet, Website, and Social Media

and General Studio Policy Form
Please select the appropriate form and follow the link to the document and signature page.

Music Lover's Studio Policy and Media Release Form (minors)

Music Lover's Studio Policy and Media Release Form (Adults)

I affirm that I have agreed to the conditions listed above regarding using my image on the internet, the Music Lover's website, and social media as I indicated in my answer choices above. I also affirm that if I am filling this form out for a minor under the age of 18, that I am the parent or legal guardian of the child, and have the ability to give consent and authorize the signature below for this media release on their behalf.

If in the event that I need to make a change in this media release agreement, Music Lover's will send another form at my request so that I can make the necessary adjustments and changes from the original one that I am signing today.
Signature*

Clear
Date*

MonthDayYear
Date
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