PBG form

Palm Beach Gardens ELEMENTARY Jan-Mar 2025 Registration

ART OF PIANO PLAYING MUSIC SCHOOL
Student`s name (only 1 student per form)*

First NameLast Name
School name*
Classroom Teacher last name*
Grade*
Day of class (as advertised on the flyer)*

Tuesday
Parent`s name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Alternative Phone Number
Please enter a valid phone number.
Email*
example@example.com
How will your child be dismissed at the end of the class? Your Child is: No walking home without a written authorizationand an accompanying adult is allowed*

Car riderAftercare
List full names of people that are authorized to pick up your child after our class (only if student is a car rider. If they go to aftercare write - N/A)*
By submitting this form you agree to the following terms and conditions:

Enrollment:

You are registering for the January-March 2025 term. Enrollment requires a payment of the partial or total balance at registration. Please note your child is NOT considered enrolled in class if you have not made a payment. If you choose to pay in installments you are responsible for the remaining installment balance per your installment payment schedule.

Enrollment Changes:

Requests for day changes or withdrawals will be processed by our office provided the request is emailed during the first two weeks of the term and there are slots available.

Cancellation/Refund Policy:

The fifty percent of the first installment payment deposit is non-refundable. The other fifty percent of the first installment payment is refundable provided the cancellation request is emailed during the first two weeks of the term. If you paid the total term balance upfront, you will be charged only for lessons you took and we will refund the rest, provided the cancellation request is emailed during the first two weeks of the term.

No refunds, credits or make ups will be given for absences, illness or disruptive behavior releases. In case of emergency a make up can be scheduled if your school offers multiple days of this class and there are slots available.

COST OF LESSONS:

SCHOOL

DAY

START DATE

END DATE

DURATION

TOTAL COST

INSTALLMENT SCHEDULE

PBG

TUE

1/7

3/18

11 WEEKS

$385

$192.50 DUE AT REGISTRATION
$192.50 DUE jAN 28

PAYMENT INSTRUCTIONS:

- Enrollment requires a payment of the partial or total balance at registration. If you need to pay in more than 3 installments please inquire via email: artofpianoplaying@aol.com

- Check out with the card is below. A surcharge of 3.07% will be applied automatically at the checkout

- If you would like to pay via Zelle (no surcharge), you can bypass the checkout below and hit the green SUBMIT button so we receive your form. To pay with Zelle, TAKE A SCRENNSHOT OF THIS PAGE FIRST

please add this number as your recepient on Zelle: 646-221-7518 (Dina Paolucci). Important: If you are paying with Zelle, we will not be able to acknowledge receipt of payment right away due to a high volume of transactions. Please call 646-221-7518 to make sure your payment was received. When making payment on Zelle, the following MUST be indicated so we know who you paid for: payment # (if paying in installments), student name, school name. Payments without notes WILL NOT be accepted

- If you are paying in installments, we will send you a reminder email with a pay link, at the time when the next installment payment is due

Once payment is submitted you will see a payment/registration confirmation on the screen. Please expect a welcome email with dates of lessons and other important information. IF YOU DON`T RECEIVE THAT EMAIL A DAY BEFORE THE START OF CLASS, YOU NEED TO CALL US RIGHT AWAY. We don`t want you to miss out on our updates throughout the term. Thank you for taking our lessons!

Pick any of the following. You may choose to pay in installments or to pay a full balance

Piano Club Lessons1st installment DUE NOW

$192.50

Piano Club Lessons2nd installment DUE JAN 28

$192.50

Piano Club LessonsFULL BALANCE

$385.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

Palm Beach Gardens ELEMENTARY Jan-Mar 2025 Registration