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.

Please complete the form below. Thank you!

I have read the above policies and agree to adhere to these policies.

Agree

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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)

(30 minute lessons) @ $28 each
(45 minute lessons) @ $39 each
(60 minute lessons) @ $52 each

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Todays Date

Student LAST name

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Student FIRST name

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Instructor

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Parent 1 LAST Name

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Parent 1 FIRST Name

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Preferred Phone Number

(Please include your area code and enter in XXX-XXX-1234 format)

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E-Mail

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Address Information

Street Address

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City

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State

(Two letters please)

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Zip Code

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Parent 2 Information

Parent 2 LAST Name

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Parent 2 FIRST Name

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Preferred Phone Number

(Please include your area code and enter in XXX-XXX-1234 format)

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E-Mail

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Street Address

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City

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State

(Two letters please)

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Zip Code

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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.

I agree
I disagree

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Instrument

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