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Registration
(Submit this form to guarantee your spot)
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Student Name
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Birthday: mm /dd /yyyy /Age
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Gender
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Girl
Boy
Parent's Name(s)
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Email
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Mobile
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Home Phone
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Mailing Address (including city/zip)
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How did you hear about us?
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Class Structure:
Every Week
Class Length:
30, 45 or 60 minutes weekly
Tuition:
$30 for 30 minutes lesson
$45 for 45 minutes lesson
$60 for 60 minutes lesson
Private Piano Lesson (Ages 4+ yrs)
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Please complete this form and let us know what time will you prefer for private lessons. Thanks
* Please bring your payment on the first day of the class.
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No refunds or credits will be given for missed classes.
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No refund will be available after 2nd class
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Class credit rollover to the next semester or school year is not an option.
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No photography or videotaping is allowed within the classrooms so as not to infringe upon the privacy of others.
* No food or drinks are allowed in the classroom
I release any and all rights and claims for damages against Mimi's Music Studio in the unlikely event
of injury sustained by myself
or my child as a result of this musical activity.
By submitting this form, you agree to the
class policies listed above
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