Registration Use the form below to complete your registration. Private Lessons Ensembles Classes Student Name * First Name Last Name Parent/Guardian Name (Required if under 18) First Name Last Name Date of Birth (Required if under 18) MM DD YYYY Email * Never miss important news! Please check the box below to be added to our mailing list. Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Preferred Payment Option Choose one, you can change your payment option at any time. Monthly Invoice (Due by the 10th) Autopay Option (Paid on the 1st) Which instrument(s) are you most interested in learning? * Which program(s) are you interested in? (Check all that apply.) Private Lessons Adaptive Lessons Enrichment Classes Rock Band String Ensemble Jazz Ensemble Percussion Ensemble Music Production & Engineering Which instrument(s) do you already play? Do you have access to an instrument for practice at home? * Yes No I would like information about borrowing an instrument from the Harmonny Lending Library Please discuss any special needs (learning, behavioral, environmental, or medical) that may be relevant to the student's instruction. * If there are none, please enter "N/A." Which days and times are best for scheduling? Weekday Mornings Weekday Afternoons Weekday Evenings Saturday Mornings Saturday Afternoons Studio Policy Bullet Points: • Please arrive punctually and prepared for your lesson. • You must contact your instructor at least 24 hours BEFORE your lesson to report a cancellation or to reschedule or you may forfeit the lesson for that week. 24-hour notice is not required for illness or emergency, please call as soon as you can. • If weather conditions do not permit safe travel at the time of your session, lessons may be made up later or conducted remotely. Contact your instructor if you are unsure. I have read and understand the above policies. More information is provided in the link at the bottom of the page. Photo Release I give Music Education Centers (MEC) permission to use photographic and/or video documentation of myself or my child for promotional and educational purposes including social media, internet publishing, staff training, and as an educational tool for other professionals.* Yes No Thank you!
