Riaan Eloff Music Academy

Standard Music Student Agreement

Enrollment

I, the undersigned, hereby enroll

(Full Names)______________________________________________________________

to study the instrument/s listed below, for the period as indicated on this form.  By signing this document, I acknowledge that I have read it in its entirety, and agree to abide by its stipulations.

Note that all courses run in quarters of 3 months. Thus, you re-enroll for continuation every three months, except for the first year, where enrollment is for a 12-month period.  Lessons take place once a week, as indicated in this form below and are an hour in length.

Instrument

Please select an instrument by making a circle around it:

Lesson Time

(Please DO NOT SIMPLY “PICK A TIME” at random.  Please fill out this part of the form AFTER COMMUNICATION with REMA, so that you may agree upon a lesson time with the instructor.)

Enrollment is for the dates starting ___________ 20____

Please circle the agreed-upon time for the lesson:

Mon   Tues   Wed   Thurs   Fri

14:00    14:30    15:00    15:30    16:00    16:30    17:00    17:30  18:00    18:30    19:00

Morning lessons are available upon special request.  Do contact your instructor about such.

Fees

Fees calculated as a per-year figure, but are paid per quarter-enrollment.  There is no per-lesson or per-month fee.  A quarter that consists of an hour lesson each week, has a fee of R3100.00 for the quarter.

Fees are due one month before the start of a quarter, in full for the upcoming quarter.  Late registrations may carry a penalty, or may be denied.

Terms and conditions

Contact Info

Email Address:

Cell Phone:

Emergency Contact Name:

Emergency Contact Cell Phone:

Any medical, psychological or other conditions that the teacher should be aware of?

Agreement

I realize that by signing this form, I bind myself to the stipulations within it, including those in “Addendum A” which is attached.  I also realize that by signing it, I confirm that I am responsible for payments, and will be held liable in the event that payments are defaulted upon.  I acknowledge and confirm that I have given all relevant information in this form, and that there is no condition, no circumstance, and no situation that may arise due to my withholding of information, for which I will hold the teacher or REMA responsible.

Promo code (if any) ____________________________

Signed on this _____ day of _______________________, 20___ at Pretoria.

_________________________________

Student/Primary Caregiver/Parent

Banking Details for REMA are as follows:

FNB current account in the name of:

The R & L Trust

Acc no:

62156642904

Branch code:

252045

Addendum A

Student Lesson Requirements