Erin Hazard Piano Studio New Student Registration
Student's Full Name (Please submit separate forms for each student from the same family):
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First Name
Last Name
Student's Birth Date:
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Month
-
Day
Year
Date
Primary Contact Name (Please list ALL parents, stepparents, or legal guardians):
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First Name
Last Name
First Name
Last Name
First Name
Last Name
First Name
Last Name
Primary Contact Phone Number (Please list ALL parents, stepparents, or legal guardians in the same order the names were provided above):
*
Please enter a valid phone number.
Please enter a valid phone number.
Please enter a valid phone number.
Please enter a valid phone number.
Primary Contact Email Address (Please list ALL parents, stepparents, or legal guardians in the same order the names were provided above):
*
example@example.com
example@example.com
example@example.com
example@example.com
Student's Home Address (If your student lives in more than one home, please provide home addresses for ALL parents, stepparents, or legal guardians in the same order the names were provided above):
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is there anything special that Erin should know about your student or your student's situation?
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Does your student have any food or other allergies? If so, what?
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I understand that monthly tuition cost for 4 weekly 30-minute piano lessons is $100/month ($25/lesson). Each month's tuition is due in full the 1st day of each month. If payment is not received in full by the 5th day of the month, a $10 late fee will be added to that month's tuition cost. Payment can be made via Venmo (@erinbhazard), Cash App ($ErinBHazard), Apple Pay, Zelle, or check.
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I understand and agree.
I understand that no-showing a lesson or cancelling with less than 24 hours' notice will result in owing the full price for that lesson, and that lesson cannot be guaranteed to be rescheduled. Any lesson cancellations from Erin's end will be refunded in full.
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I understand and agree.
I understand that by registering my student for piano lessons at Erin Hazard Piano Studio, I am committing to the Sept 2025 - April 2026 year. If I need to withdraw my child before the year is completed, I must give at least 30 days' notice; otherwise, I will be required to pay the following month's tuition in full.
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I understand and agree.
I understand that Erin has a baby with special medical needs and very fragile, compromised lungs. I will not send my student to a lesson if they are sick or if anyone in my home is sick, but will instead reach out to reschedule the lesson for when everyone is feeling well.
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I understand and agree.
Submit
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