Form of student information and policy agreement
Finger Lakes Piano Music Studio
Student Name: _____________________________________________________
Date of Birth:_______________________________________________________
Place of work, occupation:______________________________________________
Parents: ___________________________________________________________
Parents' employment, occupation:_______________________________________
Home address: _____________________________________________________
Home phone: _______________________; Mobile: _______________________
Email address: _____________________________________________________
Lesson Time: ______________________________________________________
tuition for ___ 45-minutes ___ 60-minutes for _________/per month
Start time:_____________________End time:_____________________________
I allow my video performance put on the Studio's website, YouTube or Facebook's studio page ----------
Piano Lesson Agreement
I have received and carefully read through Finger Lakes Piano Music Studio Policy. I will be responsible for monthly payment. I will obey the studio policy for the late fee, missed lesson, cancellation notice and my responsibilities to my child. I would like my child to take piano lessons from Mrs.Natalya Hennings and understand the terms of this agreement.
________________________________ ________________________________
Parent Name (please print) Parent Signature
________________________________ ________________________________
Student Name (please print) Student Signature
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Date