Age:______School Grade________Date of Birth________________
Home Telephone Number________________________________________
Mother’s Name___________________Cell Phone____________________
Father’s Name____________________Cell Phone____________________
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_______
Terri Henningson (404) 271-3177 firstname.lastname@example.org
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