Suzuki Registration
Denison Suzuki Program
Term Agreement

I, the undersigned, agree that I am financially committed to private lessons for the duration of the semester. If I decide, in consultation with my child's teacher to discontinue lessons before the end of the semester, I am still obligated to pay for all private lessons that I have registered for the semester. This policy guarantees the teachers' salaries and schedules.



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Please complete the form below. Thank you!
*
I have read the above policies and agree to adhere to these policies.
Required
Please select length of private lessons for your child. There is also a $15 program fee per student that will be added to the following rates. (PLEASE CHECK ONE) *
Required
Please select the number of lessons for your child (between 6 and 16) *
Todays Date
MM
/
DD
/
YYYY
Student LAST name *
Student FIRST name *
Instructor *
Parent 1 LAST Name *
Parent 1 FIRST Name *
Preferred Phone Number *
(Please include your area code and enter in XXX-XXX-1234 format)
E-Mail *
Address Information
Street Address *
City *
State *
(Two letters please)
Zip Code *
Parent 2 Information
Parent 2 LAST Name
Parent 2 FIRST Name
Preferred Phone Number
(Please include your area code and enter in XXX-XXX-1234 format)
E-Mail
Street Address
City
State
(Two letters please)
Zip Code
I will allow the Denison Suzuki Program to use photos or video recordings of myself or my child(ren) for publicity purposes. I understand that my name and the name of my child MAY BE included with the photo and/or video. *
Required
Book Level
Instrument *
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