Lesson Registration Form

Goal: That each student would reach his/her potential in musical skill and enjoyment.
Method: Consistency is important for student growth. Weekly lessons using a recommended method book are usually the best option for beginning students.

Lesson Registration Form

Student Name

First Name

Last Name

Instrument

Level of experience if any

Preferred Lesson Day/Time

We will contact you to confirm day and time according to instructor availability.

Parent/Guardian Information

Parent/Guardian One

First Name

Last Name

Phone

Country

(###)

###

####

Parent/Guardian Two

First Name

Last Name

Phone

Country

(###)

###

####

Payment Method

Please wait for confirmation of your lesson before paying. We will phone or email to confirm. Lesson payments can be accessed through our online store. In-store options can be done @ 16 Dundas St. W. in Trenton, Ontario.

Lesson & Payment Policies:

Lessons and registration fee ($20) are paid in advance. The lesson fee for partial months, individual lessons, or late payments is $29/lesson. The lesson fee for complete months is $26 for a 30 minute private lesson. The $26 rate applies when paying before the 1st of the month for all available weeks, or by arranging for Credit Card Auto-Pay. There is no credit or refund for missed lessons. Where the instructor is absent, a substitute will be provided at the discretion of Riverside Music. Credit will be given if no substitute can be arranged. You will not be charged for holiday closures. Be sure to confirm that we are open or closed on particular special days. If we close because of bad weather, your account will be credited. Please ask any questions about these policies BEFORE you register!

Acknowledge understanding & acceptance of policies

I understand and accept the above policies

First Name

Last Name

Lesson Registration Form

Student Name

First Name

Last Name

Instrument

Level of experience if any

Phone

Country

(###)

###

####

Preferred Lesson Day/Time

We will contact you to confirm day and time according to instructor availability.

Payment Method

Lesson & Payment Policies:

Acknowledge understanding & acceptance of policies

I understand and accept the above policies

First Name

Last Name