A.G. Studios

Where music comes to life!

Registration Form

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 to reserve your spot today.

Student Registration Form
Student  Name_____________________________________    Birthday ___________________________  

Grade ___________ School________________________________________     Years of Study  _______ 
Parent’s 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
2:00-5:00                 3:00-5:00          2:00-2:45           4:00-5:00
6:30-8:30                 6:30-8:30          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.)

*Mondays 4:00-5:30      *   Friday 4:00-5:30          *  Fridays 6:00-7:30   *  Thursdays 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 video’s 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 _______________________________________________