Online Private Lesson Enrollment Form

Online Private Lesson Enrollment Form

Please take a moment to fill out this form. It’s the first step towards our new musical journey together! As soon as I receive your information, I’ll be in touch to schedule your lessons at a time that’s convenient for you. I can’t wait to get started!
Contact Information
Is student an adult (responsible billing party)?
Student's Name*

First NameLast Name
Student's Cell*
Please enter a valid phone number.
Student's Email Address*
example@example.com
Student's Date of Birth*
Student's Age*
Student's Current Grade Level*
Parent/Guardian Name *

First NameLast Name
Parent/Guardian Cell*
Please enter a valid phone number.
Parent/Guardian Email Address*
example@example.com
Class and Goal
Which class would you like to enroll in?*
What level of the lesson would you prefer?
What is your purpose of taking lessons?
Previous Experience (if any)
Appointment
Available Day(s) of the Week For Weekly Lessons*

MondaysTuesdaysWednesdaysOther
Preferred Time Of Day*

This Online Voice Lesson Agreement is made between Eva Weingarten and the undersigned student   First Name*   Last Name* or parent/legal guardian First Name*   Last Name*  (if the student is a minor) of [Minors Full Name]    First Name*   Last Name* .

1 **Services Provided:**
The Instructor agrees to provide online voice lessons to the Student as scheduled. The lessons will be conducted via Zoom.
2. **Lesson Schedule & Cancellation**
Lessons will be scheduled at mutually agreed times. Cancellations must be made 48 hours in advance. If you must cancel within 48 hours of your scheduled voice lesson, you will be responsible for the cost of the entire lesson. All scheduling and cancellations must be made by texting Eva at 407.486.5872
3. **Payment Information**
Payment is due the same day as your lesson through Venmo (@Eva-Weingarten) or Zelle (407-486-5872).
4. **Guardian's Responsibilities:**
The Guardian agrees to ensure the Student's attendance and provide a quiet, uninterrupted environment for the duration of each lesson. The Guardian is responsible for the Student's behavior and adherence to the Instructor's guidelines.
5. **Technology Requirements:**
The Guardian is responsible for providing the necessary technology, including a stable internet connection, webcam, and microphone, for the Student to participate in the lessons.
6. **Liability Waiver:**
The Guardian agrees to release and hold harmless the Instructor from any claims, damages, or liabilities that may arise from the Student's participation in the lessons.
7. **Termination:**
  a. The Instructor may terminate this Agreement at any time with immediate effect for any reason.
  b. The Student or Guardian must provide a minimum of two weeks' notice to terminate this Agreement. Failure to provide such notice will result in forfeiture of any prepaid lesson fees.
8. **Agreement to Terms:**
Agreement to Terms:**  By signing below, the Student (if of legal age) or Guardian (if the Student is a minor) acknowledges and agrees to the terms outlined in this Agreement.

Guardian:
[Guardian's Full Name]
First Name*   Last Name*
[Guardian's Signature]   Signature*
Date*

Student:
[Student's Full Name]
First Name*   Last Name*
[Student's Signature (if applicable)]
Signature*
[Date]
Date*
Should be Empty:

Online Private Lesson Enrollment Form

Contact Information

Class and Goal

Appointment