mfMusic Studio Registration (child)
We are registering for: *
Student Name *
Your answer
Student date of birth *
MM
/
DD
/
YYYY
Student Gender *
School Type *
Name of School
Your answer
Grade in School (2019-20 Academic Year)
Has this student studied music previously? If so, please describe. *
Your answer
Is this student currently studying another instrument?
Your answer
What other after-school activities is this student currently involved in, i.e. dance, soccer, and how often each week does the student participate?
Your answer
Does this student have any dietary restrictions or allergies? If so, please describe. *
Your answer
Does this student have any physical, mental, or developmental issues pertinent to taking lessons? If so, please describe. *
Your answer
What is the student's goal for taking lessons? *
Your answer
Are there any types of music you will not allow your child to study? *
Your answer
Briefly describe the extent of both parent's musical background. *
Your answer
What kind of piano will the student be using for in-home lessons or home practice? *
Mother's Name
Your answer
Mother's Occupation
Your answer
Father's Name
Your answer
Father's Occupation
Your answer
Mother's mobile/work phone number
Your answer
Father's mobile/work phone number
Your answer
Home phone number
Your answer
Student mobile number (age 16+ only)
Your answer
Primary email address (For all studio correspondences including invoices) *
Your answer
Secondary email address (optional for families who would like all information to be sent to two separate addresses)
Your answer
Student email (optional for students age 10 and older so teacher can send assignment links, recordings, etc directly to student as needed; parent will always be CC'd.)
Your answer
Which form of communication do you prefer? *
Home Address *
Your answer
The “Lessons Swap List” allows parents of in-studio lessons to swap lesson times with other parents/students if conflicts arise. Can I list your name, email address and phone number on the "Lessons Swap List"? *
We plan to pay for tuition in the following way: *
By typing my name and date below, I am electronically signing this document to indicate that I have read the full mfMusicStudio Policy at www.mfmusicstudio.com/about-the-studio and agree to abide by the terms listed in the policy. *
Your answer
(This is optional) By typing my name and date below, I am electronically signing this document to grant Margaret Fontiveros the right to take photographs or videos of my family in connection with any mfMusic Studio event. I authorize Margaret Fontiveros to use and publish the same in print and/or electronically. I agree that Margaret Fontiveros may use such photographs/videos of us with or without our names and for any lawful purpose, including for example such purposes as web content or Facebook newsfeed.
Your answer
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