Summer Lesson Registration Form

This Form will be updated and available to send in June 2010!

SUMMER LESSONS REGISTRATION FORM

Please check the dates below that you wish to have a lesson. Consider the dates carefully. If your dates are

approved, you will be making a commitment to attend lessons on these dates. Therefore, you will be billed

in two monthly installments for your summer lessons. Your first payment, for 1/2 of the cost of the lessons,

will be due at your first lesson of the summer. The remaining portion will be due at the first lesson of the

2nd month.

Submit by _________ to reserve your time slot!

Information:

Student Name: Age:

Parent's Names:

Address:

Address 2:

Home Phone: Cell Phone: Email:

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Check only ONE day (Tuesday or Thursday) for each week

1st Month (4 weeks of lessons) Tuesdays Thursdays; June 30th July 2nd; July 7th July 9th
July 14th July 16th: July 21st July 23rd; 1st Month (4 weeks of lessons) Tuesdays Thursdays; August 4th August 6th; August 11th August 13th
August 18th August 20th: August 25th August 27th

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PREFERRED LESSON TIMES

Lesson times will be from 12:00pm to 7:00pm. Please choose a first, second, and third choice for a lesson time.

We will attempt to accommodate your time request, however if there are conflicts with other students, your time

may need to be changed. Time preference is giving to students currently enrolled first. Please be flexible!

1st Choice 2nd Choice 3rd Choice

Can you take your lesson on either day? (Tuesdays or Thursdays)

This may help to avoid a conflict. YES NO

Comments:

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