Wiliamson Music Studio - Registration Form

E-mail Address: *

Student's Name *

Date of Birth *

Current Grade Level *

Mothers Name *

Fathers Name *

Street Address *

City/State/Zip *

Home Phone *

Mothers Cell Phone *

Mothers Office Phone *

Fathers Cell Phone *

Fathers Office Phone *

Mothers email *

Fathers email *

Nanny/Babysitter Cell Phone

Best Person to Communicate to? *

Fastest and Most Effective way(s) to reach selected parent for important communications? *

Cell Phone
Text Message
Email
Home Phone
Facebook

Teacher Request

Best Days for Lessons - Click ALL days that are an option *

Monday
Tuesday
Wednesday
Thursday
Friday (Limited availability. Not available for all teachers)

Best Times for Lessons - Click ALL times that are an option *

1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm

Type of Lesson - Please select all that apply *

Piano
Voice
Guitar
Percussion
Other

Do you prefer In-Person or Online Classes *

Requested Length of Lesson *

30 Minutes
45 Minutes
60 Minutes

Payment for Lessons Fee *

Paid in Full by Check or Credit Card - Please call for semester fee
Paid in installments by Monthly Bank Draft with Debit or Credit Card. MC, Visa, Discover

Additional Comments / Information

Referred By:

I have read and I agree to the Studio Policies - Effective July 2020 *

I agree to keep my child home from lessons if the child is sick for any other reason *

I understand that the recital fee each semester is a mandatory fee and I agree to pay recital fee regardless of whether or not my child attends the recital. *

I understand that Williamson Music Studio charges semester fees rather than per lesson fees. *

I understand that registration is not complete until non-refundable $30 registration fee per student is submitted. New students will be sent an invoice that will be emailed and can be paid online. Families with a credit card on file will be charged. *

I understand that Williamson Music Studio instructors are under a non-compete agreement and I will not attempt to hire an instructor for music lessons outside of Williamson Music Studio now or at any point the the future even if I even if I discontinue lessons with Williamson Music Studio. *

Williamson Music Studio has put in place preventative measures to reduce the spread of viruses; however, the studio cannot guarantee that you or your child(ren) will not become infected with viruses. I understand that the risk of becoming exposed to or infected by viruses while attending lessons may result from the actions, omissions, or negligence of others, including, but not limited to, the owner, owner’s family, studio instructors, program participants and their families. I agree to release Jennie Williamson, her family, Williamson Music Studio Instructors and Williamson Music Studio from any and all liability for the unintentional exposure or harm due to any virus. *

I understand that when I submit this registration and I am placed on the schedule with one of the days and times that I have selected above or agreed to after registering, that I am responsible for paying the entire semester fee in full by one of the payment methods selected above, even if I withdraw before semester is completed. I have read and clearly understand the studio cancellation policy. *

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