Regional Center Registration Form

Students Name *

First Name

Last Name

Parent's Name (If Applicable)

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Lesson Length *

30 min

45 min

60 min

Type of Lesson *

In-Home Lesson (Additional $10-$15 Based On Location)

Online Lesson

Lesson At Studio

Payment Policy *

For your initial lesson, you'll only be charged for that session to ensure you're completely satisfied. If you decide to continue with weekly lessons, we'll bill you monthly in advance. Payments are due on the first of each month and cover all scheduled lessons for that period. Please direct any billing-related inquiries to the school's administrative office, not to teachers.

Lesson Rescheduling and Cancellation Policy: *

To reschedule a lesson, we require a minimum of 24 hours' notice. If a student needs to miss a lesson, they must contact the instructor directly to arrange a makeup lesson within one month. Makeup lessons cannot be carried over into successive months. For any breaks, short-term absences, vacations, or complete cancellations, students must provide at least two weeks notice.