Casual Lessons No full term commitment is made by students or teacher Student's Name * For multiple students please enrol separately. First Name Last Name Experience Beginner Intermediate Advanced Instruments Piano/Keyboard Guitar - Acoustic Guitar - Electric Guitar - Bass Drums/Percussion Ukelele Singing Violin Recorder Lesson Length 20 Minutes 30 Minutes Area * Timaru Waimate School (if applicable) Pre- School Primary School Secondary School Home School Other School Name (if applicable) Birthday MM DD YYYY Preferred Day Monday Tuesday Wednesday Thursday Friday Saturday Parent's Names / Emergency Contact Parent's Names/s Phone * (###) ### #### Email Address * Additional Required Information Have you read Expectations Agreement? Download Expectations Yes Do you have access to a device for Video Links and recordings? Yes No Do you have your own instrument? Yes No Do you give consent for images to be used for promotion? Yes No Special Notes. Please note any specific needs that affect this student's’ progress while in our care (e.g. learning difficulties; allergies, family circumstances). The Music School reserves the right to discontinue students from lessons for inappropriate behaviour; non-payment of fees; and sporadic attendance. The parent/guardian agrees to indemnify Mrs A’s Music School against all costs relating to the recovery of any monies that might be outstanding pursuant to the terms of agreement. ‘I accept’, means you have read the information above. An email with lesson details will follow and once the recipe is established your enrolment will be confirmed. I accept Thank you!
