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 * (If you do not check the box below, you will not receive information about recitals, concerts and snow days) 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 5th, $15 Late Fee if not received 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 a specific instructor in mind? Use this space to request a specific instructor 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. • Tuition payments are due on the 5th of the month, a $15 late fee is added on the 10th. 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 for
