Registration Form

REGISTRATION

 

 

Student’s Name:_______________________________________________

 

         Age:______School Grade________Date of Birth________________

 

Home Telephone Number________________________________________

 

Home Address_________________________________________________

 

Mother’s Name___________________Cell Phone____________________

 

Father’s Name____________________Cell Phone____________________

 

EMAIL ADDRESS_______________________________________________

 

                  Lesson Day____________Time_______________

 

Policy

 

1.  Payments must be made according to the monthly payment schedule.  The teacher is not obligated to give lessons for which no payment has been made, or to make up lessons which were missed when payments were in arrears.

 

2.  Notification of inability to attend a lesson is a courtesy to the teacher, but the teacher cannot excuse payment for lessons which are missed.  There will be no make-up lessons for student absences.

 

3.  Lessons canceled by the teacher will be rescheduled at t mutually agreeable time.  Refunds will be made if this is impossible.  A student absent for a make-up is responsible for payment.

 

4.  Contracting for private lessons obligates a student for a minimum of three months.  The initial three months for a new student is a probationary period, after which a consultation between the student, teacher and parent will be held to discuss and review the student’s progress.  If either party wishes, an instructional change may be made at that time.

 

5.  At the teacher’s discretion, certain lessons, either partially or in full, may be used for parent consultation.

 

6.  There is a $20 fee (in addition to the bank fee) for all returned checks.

 

The signer understands the payment  schedule and agrees to, and understands the policies stated above.

 

Signature of Parent or Guardian________________________________________date_______

 

 

 

Contact Me:

Terri Henningson
(404) 271-3177
terrihenningson@yahoo.com

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