KMA 2025 Enrolment Form
STUDENT INFORMATION
Full Name
Preferred Name:
DOB
Gender:
Male
Female
N/A
Pronouns
He/Him
She/Her
They/Them
Other
Instrument and Class of Choice
Please Select
Private Piano Lessons
Group Piano Lessons
Private Guitar Lessons
Group Guitar Lessons
Private Singing Lessons
Group Singing Lessons
Private Drum Lessons
Group Drum Lessons
Music Therapy Sessions
Allergies/Medical conditions/Learning needs
If so, list medications/care procedure (or attach Action plan)
Creative Kids Voucher Number (If Applicable):
PARENT INFORMATION
Name
Email
*
example@example.com
Contact no.
*
How did you hear about us?
Please Select
Facebook
Instagram
Website
A Friend
Westfield Performance
Other
Options for payment of fees:
Full term payment via direct transfer (no fees)
Full term payment via credit card (once off 1.75% fee)
Fortnightly direct debit (1% + 0.40 cents per transaction)
I give permission to Kennedy Music Academy to use my child's photograph/video on social media, marketing materials and their website.
*
YES
NO
Disclaimer:
I have read and agree to the KMA Student Policy.
I
understand that I am to collect my child from the studio immediately after their lesson (For primary aged students: if you wish for your child to leave the studio and meet you on the street please email us with a written permission).
Signed
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One Off Enrolment Fee
$45.00 AUD
$
45.00
AUD
Submit
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