ELIZABETH EVANS RICHTER’S PIANO STUDIO
REGISTRATION FORM
Please read the policies and procedures attached and then sign this contract for my files.
I AGREE TO THE POLICIES AS LISTED AND WISH TO ENROLL MY CHILD IN PIANO
LESSONS FOR THE 2021-2022 SCHOOL YEAR.
SIGNATURE: DATE:
(Parent)
_____________________ ________
I AGREE TO THE POLICIES AS LISTED AND WISH TO ENROLL IN THE PIANO COURSE FOR
THE 2021-2022 SCHOOL YEAR.
SIGNATURE: DATE:
(Student)
______________________ ________
STUDIO INFORMATION
Student’s Full Name: Parents’ Names:
___________________________ _________________________
_________________________
Age:______ Address:
_________________________
Date of Birth:__________
_________________________
Grade this year:________ Home Phone:______________
School:______________________ Work Phone:_______________
Email Address:________________ Cell Phone:________________
Student names & pictures may be posted on the studio website.
Student performance videos may be uploaded to YouTube and posted on the studio website.
Contact name, phone #, and email address may be placed on a "swap" list to exchange with other students.
Please check if Yes:
