🎵 MUSIC LESSONS WITH MISS EMILY 🎵

🎵 MUSIC LESSONS WITH MISS EMILY 🎵
Student Enrollment & Recurring Lesson Time Agreement
Welcome! I'm so excited to have you join me for music lessons. This form reserves your regular weekly lesson time and helps keep our scheduling and tuition policies clear and simple.
STUDENT INFORMATION
Student Name:

First NameLast Name
Parent/Guardian:

First NameLast Name
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Instrument / Area of Study:
Student Age:
YOUR LESSON
Lesson Length & Monthly Tuition
Weekly Day:
Weekly Time:

Hour Minutes

AM/PM Option
Start Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
MONTHLY TUITION
Your monthly tuition reserves your regular weekly lesson time with Miss Emily.

Most months will have four lessons. Because of the way the calendar falls, some months will have three lessons and some will have five lessons.

Monthly tuition remains the same regardless of whether a month contains three, four, or five scheduled lessons. This allows your weekly lesson time to remain reserved for you throughout the year.
MAKEUP LESSONS
I understand that life happens! Students may receive up to two makeup lessons every four months for lessons missed by the student.

Makeup lessons must be arranged in advance and are subject to availability. Makeup lessons may take place on a different day or time than the student's regular lesson.

Unused makeup lessons do not carry over into the next four-month period.

If Miss Emily needs to cancel a lesson, the lesson will be rescheduled or an appropriate makeup lesson will be provided.
CANCELLATION POLICY
Your weekly lesson time is reserved specifically for you.

If you decide to discontinue lessons, 30 days' written notice is required.

Tuition remains due during the 30-day notice period. After the 30-day notice period has been completed, your recurring lesson time will be released.

Simply stopping attendance does not cancel the 30-day notice requirement.
PAYMENT
Preferred Payment Method:

Other text input
Monthly Tuition: $
Payment Due Date:
If automatic payment is selected, I authorize Miss Emily to charge the payment method on file for the applicable monthly tuition.
MY MUSIC-LESSON PROMISE

My goal is to create a positive, encouraging, and fun environment where students can grow as musicians, build confidence, and enjoy making music.

By signing below, I acknowledge that I have read and understand the lesson policies outlined above, including tuition, the recurring lesson time, makeup lessons, payment, and the 30-day cancellation policy.
Student Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: