4/4 School of Music REGISTRATION

Registration Form

Fill this out AFTER you have taken your first lesson :)

Please call us to setup a free introductory lesson. 425-485-8310

You MUST answer all questions that have * next to them.
Use the TAB key to move between fields. The ENTER key will send your registration.


THE STUDENT
*Name (First \| Middle \| Last)
Male/Female (M/F)	Birthday (Month/Day/Year) / /

* Phone 1	Description
* Phone 2	Description
Phone 3	Description
Email (Snow Days, etc.)
* Street Address	Apartment #
* City	State * Zip

* Instrument
* How did you hear about us?
Notes, Comments, Suggestions
Allergies, Learning Disorders, etc.
CONTACT PERSON (for scheduling, billing, etc.) (Usually parent or guardian if student is not 18 years old)
*Name (First )	(Last)
* Relation to Student

* Phone 1	Description
* Phone 2	Description
Phone 3	Description
Email (Snow Days, etc.)
* Street Address	Apartment #
* City	State * Zip

4/4 School of Music L.L.C. - Student Agreement

You must read and sign each section of the agreement below

This section, the Missed Lessons section and the Withdrawal and Refunds section applies to private lessons and classes that are continuous. They do NOT apply if you are purchasing a specific number of lessons (gift certificates or group lessons with a specified end date). *** Group lessons (classes) cannot be cancelled, rescheduled or credited for any reason. I wish to be scheduled for weekly music lessons from now on until I submit a withdraw form. I agree to pay monthly tuition. Tuition is the same amount each month. I understand tuition is by the month NOT per lesson and the only way to reduce the normal monthly tuition fee is by submitting a vacation notice in writing or using the online form 30 days prior to my being gone. I also understand that there is a one month minimum enrollment period. Q. How many lessons will I receive each month? In most months there are four lessons. Due to holidays in December, SOME students will only receive 3 lessons and will only be charged 75% of normal monthly tuition. Please click our “Calendar” button at 44school.com and look at the December schedule to see if this affects you.

* I have read and understand this section (Sign by typing your name)

Please call customer service at 425-485-8310
for ALL cancellations and schedule changes!
Your teacher cannot accept cancellations or withdrawals.

Missed Lessons
Cancellations - If you cancel your lesson with less than 24 hours notice, the lesson CANNOT be made up and you will be charged for the lesson. Rescheduling - If you cancel your lesson with 24 hours or more notice, you will be offered a makeup lesson (Makeup lessons must be taken within 30 days of the cancelled lesson). Vacations – With 30 days or more notice, we can reduce your monthly tuition if you won’t be able to attend all scheduled lessons.

* I have read and understand this section (Sign by typing your name)

You MUST submit a withdrawal form in order to stop charges to your account.

Withdrawal and Refunds
If our office doesn’t know about your withdrawal, we will continue to charge you for lessons. Your teacher CANNOT withdraw you. Withdrawal must be done at least 10 days before your next billing date by filling out a withdraw form (found online at http://www.44school.com/withdraw_form.htm). No refunds, please attend all of your lessons. 4/4 School of Music reserves the right to terminate lessons to any students without notice. In this situation a refund for unused lessons will be given.

* I have read and understand this section (Sign by typing your name)

Photo Release
The school is hereby granted permission to take photographs of the students to use in brochures, web sites, posters, advertisements and other promotional materials the school creates. Permission is also hereby granted for the school to copyright such photographs in its name.
Yes No

The school reserves the right to provide a substitute teacher if the regularly scheduled teacher is ill or otherwise unable to attend a lesson. If the teacher is ill and the school cannot arrange a substitute, any missed lessons will be rescheduled. The school is not responsible for providing before or after class care for students nor is the school responsible for visitors at any time. Parents are asked to remain in the school during classes. Students are not to be left at the school for an excessive period of time before or after lessons. Parents, legal guardians, students & visitors waive the right to any legal action for any injury sustained at any school location or property resulting from the normal lesson activity or any other activity before, during, or after lesson time. By typing my name in the box below, I acknowledge that I have read and understand all policies and procedures and agree to abide by them.

* Date
* Signature of Parent or Adult Student

Click here to print a copy of this agreement for your records
then click the SUBMIT button to send it to us.

Please call customer service at 425-485-8310 for ALL cancellations and schedule changes! Your teacher cannot accept cancellations or withdrawals.

You MUST submit a withdrawal form in order to stop charges to your account.

Photo Release The school is hereby granted permission to take photographs of the students to use in brochures, web sites, posters, advertisements and other promotional materials the school creates. Permission is also hereby granted for the school to copyright such photographs in its name. Yes No

Please call customer service at 425-485-8310
for ALL cancellations and schedule changes!
Your teacher cannot accept cancellations or withdrawals.

Photo Release
The school is hereby granted permission to take photographs of the students to use in brochures, web sites, posters, advertisements and other promotional materials the school creates. Permission is also hereby granted for the school to copyright such photographs in its name.
Yes No