If you are currently a student and would like to sign up for the next semester , feel free to print this form and bring it to lessons, along with your registration form to reserve your spot today.
Student Registration Form
Student Name___________________________________ Birthday ____________________
Grade ___________ School________________________________________
Years of Study _______
Parents Name ____________________________ Cell Phone number_______________
Mailing Address _______________________________________________________________
Preferred means of contact: (please circle) Email / Phone Call / Texting
Home Phone ___________________Emergency Contact (other than parent) _________________
Allergy /Special Needs ______________________________________________________________
___ 30 minute traditional piano ____30 minute vocal ___ 60 minute vocal/piano combo
___ 45 minute traditional piano ____ 45 minute vocal ____45 minute piano/chordal combo
____ other (add to piano or voice combo of drumming/theory/worship team/improve/)
Fall Studio Hours
Monday Tuesday Wednesday Thursday
2:00-6:00 2:00-6:00 1:45-2:30 4:00-5:00
6:30-9:00 6:30-9:00 6:30-8:30
Please share your top three lesson slots including day and time based on my hours.
1. ___________________________________________
2. ___________________________________________
3. ___________________________________________
Please circle all group lesson time slots that work with your schedule to help me determine group lessons. (Group Lessons/parties will happen 1-2 times a semester and will replace normal lessons that week. I hope to divide up age groups for smaller groups at times if schedules allow.)
*Mon. 4:00-5:30 *Mon. 6:00-7:30 *Fri. 4:00-5:30 *Fri. 6:00-7:30 *Thurs. 6:00-7:30
Yes/No I give permission for my child to pick from the prize box that may include food items.
Yes/ No I give permission for my child's picture and first name or initial to be used in publications for A. G. Studios.?
I'd love to add congratulations when finishing a level, acknowledging accomplishments, or showing games/activities we do.
Yes/No I give permission for my child to be in videos promoting A.G. Studios or showing cup percussion/recital/ or other activities.
A picture or video is a great way to truly show what is happening in studio.
Payment info: ______ I will make my tuition payment in two monthly installments
______ I will make my tuition payment up front for the semester
I understand that I am committing to a full Semester of music lessons that can be paid in monthly payments at the first lesson of each month or one payment at the beginning of the semester.
I understand that Fall & Spring semesters do not allow for makeup lessons due to a full schedule.
I have read and understand the above information and have read the policies at http://www.freewebs.com/agstudios/studiopolicies.htm .
Date ________________________ Name ________________________________________