REGISTRATION AND AGREEMENT

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* NAME_________________________________________________

* DATE OF BIRTH ___________  DD/MM/YY

* ADDRESS________________________________________________________________________

* CITY___________________________________________* POSTAL CODE__________________

* TELEPHONE: HOME_______________________________CELL___________________________

WORK____________________________

E-MAIL_________________________________________________________________________

* PARENT/GUARDIAN_____________________________________________________________

* INSTRUMENT (PLEASE CHECK)

PREFERRED TIMES__________________________________________________---____________

TEACHER REQUESTED (IF AVAILABLE) ______________________________________________

I have read and accept the Studio Policies. I understand that there are no refunds once the course or lessons have commenced.

I agree that I am responsible for lessons that are missed and any workbooks used.

SIGNED____________________________________________DATE_________________________

* INFORMATION REQUIRED

___________________________________________________________________________________