Music Lessons Contract Music Lessons Contract Student Name * Student Age * Birth Date * Previous Student? * yes no Street Address * City * Zip Code * Parent(s) Name(s) * Home Phone Work Phone * Cell Phone * Email * Emergency Contact Name * Emergency Contact Phone * Select Preferred Lesson Information Preferred Lesson Day(s) ? Monday Tuesday Wednesday Thursday Friday Saturday Preferred Lesson Time 8:00am 9:00am 10:00am 11:00am 1:00pm 2:00pm 3:00pm 4:00pm4:00pm 5:00pm5:00pm 6:00pm6:00pm 7:00pm7:00pm 8:00pm8:00pm Preferred Lesson Start Date Lesson Duration * Trial 30 min 45 min 60 min Preferred Instructor (if any) Family who's taken/taking lessons: How did you hear about us? Goals or Wishes Agree to Payment Information Here All lesson fees must be paid by the month in advance in order to reserve the student’s lesson time (i.e., January 1st, February 1st, etc.). You are receiving a discounted and fixed rate to pay by the month. The monthly rate is $80 per one half hour, $115 per 45 minutes and $160 per hour of lesson time. Individual lesson fees are $30 per one half hour and $60 per hour of lesson time. Please inquire about prices for group lessons. You must stay prepaid to reserve your lesson time. There is a $15 registration fee for the first student and a $10 registration fee for each additional student when they sign up at the same time.Lessons are scheduled at the same time (and day) each week. Lessons scheduled upon student’s return from vacation must be paid in advance prior to the missed lessons, otherwise the student will forfeit his/her lesson time to another student. Student may discontinue lessons at any time with a required two (2) week notice given by completing an “ending form” at our store. This protects you from being charged for extra lessons. Unused lesson fees are held as credit to your Music Showcase, lesson or store, account and are not refundable. If understood, please enter initials here: * Payment can be made monthly either in cash, money order or credit card as long as the account is prepaid. Most customers are on autopay. Customer can authorize Music Showcase to charge their credit card for lessons. I authorize Music Showcase to charge the monthly lesson payment to my valid: Visa Mastercard Discover Credit Card Account Number * Credit Card Expiration Date * Credit Card CVV * Customer Digital Signature * *If credit card fails to process, then customer must update the credit card or make other payment arrangements. Should I fail to pre-pay or should I leave an outstanding balance upon ending lessons, I authorize Music Showcase to charge the balance owed to the credit card number on file. If understood, please enter initials here: * Agree to Delinquency Policy Here A late fee of $15 will be applied to a student’s account for delinquency in payments if (1) notification of an outstanding balance generates no response or action from the customer or (2) a monthly paying customer is past due on his/her payment as of the 14th of the month. If understood, please enter initials here: * Agree to Attendance & Cancellation Here It is important to understand that teaching is an instructor’s job. Whether you show or not, he/she is present and must get paid. Each instructor takes time to prepare for each lesson and takes pride in each student’s success. Success can only be achieved and goals reached with perseverance and dedication. Parents must be responsible to make sure their personal schedule does not conflict with the student’s lesson time, and in turn, his or her progress. We request that parents be prompt in attendance and when picking up their child so as not to create a delay in the next student’s lesson time, especially if you wish to meet with your student’s instructor. A reserved time slot is guaranteed for each student as long as his/her account balance is kept prepaid. Students are allowed to make up any cancelled lessons within 30 days. If an instructor cancels, every effort will be made to provide a substitute or make-up lesson for your student. If there is an emergency, injury, or illness and you need to cancel for several weeks or an extended period of time, please discuss your options with our staff before discontinuing your lessons. Cancellations can be made by either calling Music Showcase, by filling out a cancellation form in advance at the Education Center, or online. PLEASE DO NOT END OR CANCEL WITH YOUR INSTRUCTOR. A number will be assigned to your cancellation for our records as well as for yours. Fees for unattended lessons due to “no shows” will be forfeited. Note: It is not the teacher’s responsibility to inform management of a student’s vacation or cancellation. If understood, please enter initials here: * We understand emergencies will occur; however, please notify Music Showcase as soon as possible, so we can handle your account properly. We request the parent/student give Music Showcase a minimum of two (2) weeks advance notice of permanent or long-term cancellation in writing. One (1) or more missed lessons without explanation (No Shows) will warrant immediate cancellation if there are no monies on account as credit. If understood, please enter initials here: * Other Important Information It is the parents responsibility to inform the instructor or Music Showcase of any known health limitations or special learning needs or gifts in compliance with the Individuals with Disabilities Education Act. Music Showcase encourages their students to perform and showcase what they’re learning in lessons. There are multiple recitals in the Music Showcase auditorium and opportunities to perform at various community events throughout the year. Students can also further their musical growth by participating in clinics with well-known professionals and workshops. Students and parents should ask their instructor or a school representative about participating in the concerts. Since the opening of the school, we have grown and are making a lot of positive changes. Due to the growth and excitement of our students, we are always trying new things (i.e., recitals, clinics with well-known professionals, concerts, etc.). We are open to any other suggestions. Please ask your instructor or visit our website about monthly recitals and other events. Digital Form Signature * By entering your name, you are giving us your valid digital signature. 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