Private Music Lesson Registration
PLEASE NOTE THAT STUDENTS MUST COMMIT TO A FULL TERM OF LESSONS: Eight lessons in the Fall and Spring Terms ($440), ten in the Winter Term ($550). See the complete rules and guidelines for music lessons at
Student FIRST Name
Student LAST Name
Student's Grade Level
Senior / PG
Student Cell Phone Number
Student Email Address (@deerfield.edu)
Free Class Periods
Please indicate which periods are available for weekly lessons. (If you have no free periods, don't check any boxes. It may still be possible to schedule your lessons at other times.)
What do you wish to study?
For how many years (if any) have you previously studied this instrument?
Commitment to Lesson Fees
I attest that I have spoken with my parents and have gotten their permission to sign up for music lessons. My parents are aware that they will be charged for the cost of these lessons on a term-by-term basis, and they have read the lesson rules and regulations.
I am the parent or guardian of this student and I give permission for this student to sign up for music lessons. I understand that I will be charged for these lessons on a term-by-term basis, and I have read the lesson rules and regulations.
Best way to reach parents?
Please provide a phone number or email address.
Never submit passwords through Google Forms.
Terms of Service