SMAS Student Registration Form

SMAS Student Registration Form

Please complete, sign, and submit this form.
Student Information
Student Name*

First NameLast Name
School*
Grade*
Parent/Guardian Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Known Allergies
Do you allow the uploading, recording, or distribution of your child’s photo/video in any medium (including the internet) for advertisement and educational purposes?*

Yes, if faces are hiddenYesNo
Lesson Details
Lesson Day*
Monday, Tuesday, ...
Instrument

PianoViolinFluteVocalArtPreschool Music
Lesson Start Date

MonthDayYear
Date
Lesson Duration

60 mins45 minsGroup Lesson 60 minsCreative Art(1.5h)Senior Art(2h)
Payment Plan: Full tuition must be prepaid by the 1st day of the month, depending on the number of lessons each month.
Tuition & Payment Information
Music Lessons:

Private (1 hour) - $60 (Seraphina $70)Group (1 hour, 2 students) - $35 per studentPreschool Group (1 hour, 4 students) - $25 per hour
Art Lessons (*Materials included)

Creative 1.5 hours - $40Senior Art 2 hours - $100
Camps:

Summer Camp -$300/weekMarch Break -$300/week
After-School (* Additional violin or piano lessons can be added for an extra $100. No lessons are held on school holidays or public holidays.)

Option 1: Full-Time Program($500)Option 2: Part-Time Program($350)
Payment Method*

CashChequeE-Transfer (Email: smas202532@gmail.com)
*Full tuition must be prepaid by the 1st day of each month.
Cancellation & Make-up Policy
Cancellation of a lesson must be made AT LEAST 24 HOURS prior to the scheduled lesson time in order to receive a make-up lesson or credit. Cancellations made with less than 24 hours' notice will be charged in full. (This does not apply to afterschool students.)
Practice Expectations
Students are encouraged to practice at least [beginner-30 mins / intermediate-1 hour] per day, EVERY DAY(at least 5 days) a week. A practice log will be provided to track progress. (Afterschool students may apply differently; this will be discussed with the teacher and parents.)
Materials
Students are responsible for purchasing their own music books/materials. The teacher will provide book recommendations based on the student’s level.
Parent/Guardian Involvement
For younger students, parental involvement is encouraged to help with practice. Parents are welcome to sit in on lessons if necessary but should remain quiet and avoid interruptions.
Recitals & Performances
Students are encouraged to participate in recitals(June/December), festivals, and performances as part of their musical growth. Information will be provided in advance. ( Afterschool students may apply differently; this will be discussed with the teacher and parents.)
Termination of Lessons
If a student wishes to discontinue lessons, one month’s notice is required. The teacher reserves the right to terminate lessons if the student consistently fails to meet practice or attendance expectations.
Communication
For any questions or concerns, please contact Seraphina Kim at smas202532@gmail.com / 902-817-7007. Open communication is encouraged for a productive learning experience.
About the Student

Please discuss these questions with the student and provide as much information as possible to help customize their lessons.
Why does the student want to learn piano/music? (e.g., Fun, RCM Exam, Stage Experience, etc.)
Favorite music genre (e.g., Disney, pop, K-pop, game music, etc.):
Favorite character:
Things the student is interested in (hobbies, etc.):
Practice times outside of class:
Previous concert or stage experience:
Special requests:
Seraphina’s Music & Art School Contact Information
- Phone: 902-817-7007
- Email: smas202532@gmail.com
Liability Waiver
I, Parent Name* , as the parent/guardian of Student Name* acknowledge that participation in our studio program involves certain risks. I release Seraphina’s Music and Art and its staff from any liability related to injuries or incidents that may occur.
Parent/Guardian 1 Signature*

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Date:*

MonthDayYear
Date
Agreement and Signature

By signing below, I confirm that the above information is accurate and that I agree to adhere to the studio's policies and guidelines.
Signature*

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SMAS Student Registration Form

Student Information

Lesson Details

Tuition & Payment Information

Cancellation & Make-up Policy

Practice Expectations

Materials

Parent/Guardian Involvement

Recitals & Performances

Termination of Lessons

Communication

About the Student

Seraphina’s Music & Art School Contact Information

Liability Waiver

Agreement and Signature