Individual Lesson Registration 

Below is the agreement form that is required to be filled out and completed prior to beginning lessons at Music Pillars.

 

Please complete the form below (AND PLEASE ZOOM IN if needed- the Small print is not on purpose - we promise - its a glitch!)

PARENT/GUARDIAN INFORMATION
Please select the studio location that you are registering for
Parent/Guardian Name *
Parent/Guardian Name
Home Address *
Home Address
Parent Cell Phone *
Parent Cell Phone
STUDENT INFORMATION
Student Full Name (No.1) *
Student Full Name (No.1)
If you are enrolling more than one child into individual lessons - please list each of them separately below
Student Full Name (No.2 - if Applicable)
Student Full Name (No.2 - if Applicable)
Student Full Name (No.3 - if Applicable)
Student Full Name (No.3 - if Applicable)
Studio Agreement
Credits Continued
Credits have the following limitations/stipulations
Number of Credits per year *
*Credits are allocated based upon when a student begins study at MP. Please select the month in which your first lesson will take place
Electronic Signature
Please type your full name below to indicate that you have reviewed and accepted the studio terms for individual lessons at Music Pillars