Child's First Name: ____________________Last
Name___________
Address:___________________________________Zip_______________
Gender: Male ___ Female ___ Date of Birth if Minor _________________
FOR
ADULT STUDENT / PARENT OR GUARDIAN INFORMATION
First Name: ____________________Last Name____________________
Cell Phone:____________________Home Phone____________________
E-mail
Address:________________________________________
First Name:____________________Last Name____________________
Cell Phone:____________________Home Phone____________________
E-mail Address:________________________________________
How did you hear about us?____________________________________
Registration fee for first semester of $40.00 is required at sign-up. Continuing Students per semester is $20.00.
Fee for registration and materials are non-refundable.
Payment options for Children's Curriculum:
1. Check/ Pay in Full/ Post Dated Checks 2. Credit Card/ Pay in Full 3. Credit Card/
Payment Plan
Tuition Fee: $360.00 Per Semester (16 Lessons)
Lesson Length: Approximately 45 minutes
Students Materials: $75.00
per Semester
Payment Plans:
a. The Payment Plan allows YMES students to split the tuition in 3 payment over a semester by credit card
or checks.
b. A one-time non-refundable administrative fee of $25.00 will
be applied to the first charge.
c. Your American Express, VISA or Master
Card card will be charged automatically according to the payment schedule.
Payment Schedule:
Initial 1/3 tuition, materials, registration & Payment Plan fee
due upon pre-registration. 2nd 1/3 tuition due on or before __________ Final 1/3 tuition due on or before __________
Family Discount: A discount of 10% off the total tuition is given after the first of two
or more enrolled students.
WITHDRAWAL/ REFUND POLICY
Non-atttendance is not considered a withdrawal. Fees and tuition are non-refundable. Refunds
will be given in cases of insufficient enrollment that results in the cancellation of a class.
Withdrawal 45 business days in written request by parent/student must be acknowledged by Lozada School of Music prior
to the start of a semester for a full tuition refund.
Otherwise, there will be
no refund. No exceptions.
For your convenience, students will be automatically
re-enrolled for the following semester.
MAKE UP POLICY
Missed Lessons: Teachers will make homework assignments available via e-mail for missed lessons.
All missed lessons because of teacher absence or weather-related school closing will be made up.
SCHOOL CANCELLATION / CLOSING POLICY / HOLIDAY BREAK
Please call
the school to verify the status of classes during times of inclement weather or other emergencies. Please note that
the school does not necessarily follow the weather cancellation decisions or scheduled breaks of the local public schools.
RELEASE
I
understand that all students may be photographed and video recorded while at the studio or in performance and understand that
these pictures/videos may be used in flyers, advertisements, school website or social network sites without compensation.
I give Lozada School of Music full permission to use them.
AGE
POLICY FOR BEGINNING COURSES: YMES students must meet the following age criteria:
Junior Music Course 1
(Age 4-5 must be 4 by September 15.)
Young Musicians Course 1 (Age 6-8 must be 6 by September 15.)
Keyboard
Encounters Kids Course (Age 9-Up)
Keyboard Encounters (Adult)
SUMMARY AND CHOICE
OF PAYMENT
Full payment Cash, Check, Debit Card, Mastercard,
Visa or American Express for __________
Or 3 Payments for your convenience, will include a $25.00 processing fee:
Payment today $______________ , 2 postdated checks/
2 credit card charges: Dated _________, $_________, Dated __________,$____________
AGREEMENT
The signer understands and agrees to the above policy and accepts responsibility of all charges and fees towards
the entire FULL semester and any other fees that may be incurred.
_______________________________________________________________________
Please Print Name
Signature
Date
