Intake Form
Fill out this brief form to schedule your Private Music Lesson!
Student Name
*
First Name
Last Name
Student Age
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Parent/Guardian Name (N/A if student is over 18)
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First Name
Last Name
Best Contact Phone Number
*
Please enter a valid phone number.
Best Contact Email
*
example@example.com
What lessons are you interested in taking?
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Piano
Voice
Guitar
Bass
Drums
Ukulele
Violin
Saxophone
Flute
Clarinet
Trumpet
Music Theory
Songwriting
Beatboxing
Other
Duration of Lesson
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30 minutes
45 minutes
60 minutes
Type of Lesson
Private Lesson (One-on-one)
Semi-Private Lesson (2 students. Parent/Child, Siblings, Couples)
Online Lesson (Virtual Studio via Zoom)
Which Payment Plan would you like to select? (Visit kx2music.com/lesson-packages for more info)
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Quad (4 lessons)
Deca (10 lessons)
Venti (20 lessons)
Introductory Lesson (30 mins. One-time payment)
Please select which days and times you are available for lessons. *Afternoon indicates 2:00pm-5:00pm, Evening 5:00pm-8:00pm.
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Monday Afternoon
Monday Evening
Tuesday Afternoon
Tuesday Evening
Wednesday Afternoon
Wednesday Evening
Thursday Afternoon
Thursday Evening
Friday Afternoon
Other
Is there anything else you would like us to know?
Agreement
Fees must be paid in full before the first lesson. Lessons will be suspended if payment is not complete. All lesson payments are final. Lessons purchased must be used within 6 months. Lesson fees are subject to annual review. Lessons are purchased in packs of 4 (Quad), 10 (Deca), or 20 (Venti). We offer one introductory lesson to serve as a trial assessment. Introductory lessons are 30 mins. After the Introductory lesson, subsequent lessons are recurring weekly. All Fees are visible on kx2music.com. A minimum of 24 hours notice is required, otherwise, the client is responsible for full payment of the Lesson. Lessons cancelled with appropriate notice will be rescheduled. In the case of an emergency, the lesson will be held online or rescheduled at the Teacher's discretion. If a Lesson is cancelled under 24 hours and the Teacher agrees to reschedule, the rescheduled lesson cannot be cancelled, even with appropriate notice. If the client still decides to cancel the rescheduled lesson, the client is responsible for full payment of the Lesson. If the Teacher is unable to give any scheduled Lesson, the Lesson will be arranged for another date. To maintain a healthy environment, students exhibiting symptoms of illness should not attend in-person lessons. The Student/Parent/Guardian is responsible for any damage incurred by the Student to an instrument, accessory, or music owned by Kx2 Music. The Teacher must be informed of any medical or other condition affecting the Student. Any lesson time missed by the Teacher will be made up; Any lesson time missed by the Student (i.e., lateness) is not required to be made up by the Teacher. Students are required to bring a folder or binder and their individual instrument (if applicable) to each lesson. Photos/Videos may be taken at Showcases, Recitals, Summer Camps, or other various performances, and shared on the official Kx2 Music sites. If the Student is under the age of 18, the Parent/Guardian gives permission for the Teacher to teach the Student at the agreed lesson location and scheduled time, even if the Parent/Guardian chooses to not be present on the premises during the lesson. Parents/Guardians are responsible for the supervision of students before and after their scheduled lesson time.
Please Check Box to Proceed.
*
I understand & agree to the terms above.
Thank you! We look forward to meeting you!
We will contact you shortly.
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