Registration For New Fall Piano Student

Group Lessons
Student's Name:*
Parent Name:*
Additional Parent Name:
Home Address:*
Primary E-mail: This email will receive all communication from Arrow AND receive INVOICE emails.*
Secondary E-mail: This email will receive all communication from Arrow, EXCEPT invoice emails.
Primary Cell Phone: If possible, please list a number that will accept text messages.*
Secondary Phone:
Student's Birthdate:*
Student's grade in school (Fall 2017):*
Student's School (Fall 2017):*
Does your child have any special needs we should consider?*
How did you learn about Arrow Academy? (If you learned of us through a friend, please be sure to include their name so we can thank them!)*
In a few words, please tell us why you want your child to take music lessons:*
Select lesson option:*
The fall session begins mid August and concludes at the end of May. NOTE: Completion requires attendance for the entire course.*
Lesson Availability - Select each day that may apply*
Earliest time available for lessons:*
Latest time you would be able to stay for lessons:*
Please plan to attend each lesson with your child if he/she is in first grade.*
Is there any other information that would assist in the scheduling process? (e.g. Activities, clubs, sports, etc.)
Materials fee is $129. Materials fee is due upon registration and is non-refundable. First month tuition (August) is $99 and also due upon registration. The total due at registration is $228.*
What method of tuition invoicing would you prefer?*

Our Studio Policy document includes our guidelines regarding make-up lessons and tuition payments. *

I hereby authorize Arrow Academy of Music, hereafter referred to as “Company,” to publish photographs and/or videos of myself and/or the minor child or children listed in this registration for use in Arrow Academy of Music's print, online and video-based marketing materials, as well as other Company publications. I hereby release and hold harmless Arrow Academy of Music from any reasonable expectation of privacy or confidentiality for myself and for the minor child and children listed below associated with the images specified above. Further, I attest that I am the parent or legal guardian of the child or children listed below and that I have full authority to consent and authorize Arrow Academy of Music to use these images in any lawful way. I further acknowledge that participation is voluntary and that neither I, the minor child, nor the minor children will receive financial compensation of any type associated with the taking or publication of these photographs or participation in company marketing materials or other Company publications. I acknowledge and agree that publication of said photos confers no rights of ownership or royalties whatsoever. I hereby release Arrow Academy of Music, its contractors, its employees and any third parties involved in the creation or publication of Company publications, from liability for any claims by me or any third party in connection with my participation or the participation of the minor children listed below.*
Since you do not wish to have your child appear in photographs and videos published by the studio, please understand that it is your responsibility to prevent your child from joining group photographs/videos.
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