Foxx Piano Studio Re-Registration
Has your address changed in the last year?
Yes (please update address below)
No (can skip updated address)
Street Address Line 2
State / Province
Postal / Zip Code
Has your phone number changed in the last year?
Yes (please update number below)
No (can skip updated number)
Updated Phone Number
Can you receive texts?
For reminders, please check which you prefer? (Weekly lesson reconciliations will come via email)
Grade in 2021-2022
Student t-shirt size
Youth S (6-8)
Youth M (10-12)
Youth L (14-16)
Youth XL (18-20)
During music lab, I only use websites that are appropriate for children and music related. Does your child have permission for this?
Do you have an Apple iPad with at least iOS 9 or later?
Not now but will be getting one (keep me updated when you do)
What are the student goals and parent expectations in lessons this year? (Please be specific)
Does your child have any special needs (autism, ADHD, dyslexic, learning needs, psychological or physiological conditions) that would need special consideration? (This info helps me set students up for success and will remain confidential)
Students eyesight and hearing:
List extra-curricular activities and what kind of demands they will make with their time:
List any other interests or hobbies:
Does your child have any food allergies? If so, please specify.
What kind of piano is your child practicing on at home?
If acoustic piano, please check the following to describe...
Piano is tuned
Everything functions correctly (keys, pedal, etc)
Piano is not tuned (will get it tuned)
Parts on the piano do not function
If digital or electric keyboard, please check the following to describe...
Less then 61 keys
All 88 keys
Touch Sensitive (when keys are pushed it can play loud and soft depending on how hard it is pushed)
Weighted Action (keys are heavier and can also do dynamics)
Pedal (plug in or attached)
All the parts function correctly
Parts on the piano do not function
Do you prefer lessons online or in person?
Please check which lesson format you prefer. Lesson choices are based upon availability. *Yearly tuition includes but is not limited to weekly lessons, group lessons, core music as needed each semester AND camps or practice packets. The monthly payment does not change regardless of the actual number of lessons per month. *
PR30- $170.00 a month: 30 min. Private lessons for 5 years and up and does not include the lab bonus.
PR60 (w/ lab bonus)- $170.00 a month: Private lessons with lab are 60 minutes for students 7 years and up. 30 minutes is private lesson time; a bonus of 30 minutes is piano lab. (Lab will take place during another student’s private lesson time).
Rotating Lessons- $145.00 a month: (Based upon availability) Rotating lessons are for students 6 and up follow a lighter course of repertoire. Regular practice is still expected. Rotating students attend weekly for 60 minutes and rotate in 20 min. stations. Each student will receive private time with the teacher during that hour.
How would you like to make your tuition payments? (*Full semester checks or postdate semester checks will receive a $25.00 per semester discount)
Automated Credit Card or ACH payments (Monthly payments Aug-May)
Full Year by Credit Card (Aug-May)
*Two postdated checks for each full semester (dated Aug and Jan) [includes discount]
*Postdated Checks By the Year (dated monthly, Aug-May) [includes discount]
Please check which optional events you would like to participate in? (Event fees are non-refundable and due by September 1st or when you begin lessons) Not listed is our spring recital held the 2nd Saturday in May where all students will participate.
Masquerade- A Halloween themed event held in October, hosted by Riverton Piano. Students have the opportunity to play for family and friends and dress up in costume. A fun and relaxed performance opportunity for all! (Prerequisite: None, Fee: None)
Music at the Mall - Held in December, a program hosted through PMTA. This is an enjoyable event where students perform a Christmas piece at Arrowhead Mall. A great way to welcome in the holiday spirit! (Prerequisite: None, Fee: $10.00)
Spring Festival - A TBA themed event hosted by Riverton Piano. A fun and relaxed performance opportunity for all! (Prerequisite: None, Fee: None)
Piano Ensemble - A PMTA concert experience you will not forget! Twelve pianos are placed on a stage and students perform their number all together with a conductor. Students are paired with a duet partner and assigned a specified piece (Primo OR Secondo). The teacher will place students in a group based on ability to play the piece up to tempo and ability to FOLLOW A CONDUCTOR. Attendance at 3 week night rehearsals is required. Students participating 4 years or more receive special recognition. Make this a goal to be able to participate. (Prerequisites: 8 years old and older, 2 years of lessons and/or duet experience; ability to play with a steady and accurate rhythm in a group setting. Fee: $30.00* *Includes music)
Please review studio policy and agreement below...
I have read, understand and agree to the Foxx Piano Studio policy and agreement.
Should be Empty:
Now create your own JotForm - It's free!
Create your own JotForm