2017-2018 Piano Registration (Child)
August 28, 2017-May 21, 2018
Student Information
Student Name
Your answer
Student Name (2nd Child)
Your answer
Student Name (3rd Child)
Your answer
Birthday
MM
/
DD
/
YYYY
Birthday (2nd Child)
MM
/
DD
/
YYYY
Birthday (3rd Child)
MM
/
DD
/
YYYY
School Grade
Your answer
School Grade (2nd Child)
Your answer
School Grade (3rd Child)
Your answer
Parent Information
Parent Name
Your answer
Email
Your answer
Cell Number
Your answer
Address
Your answer
Emergency Contact
Your answer
Emergency Contact cell number
Your answer
Tuition
Tuition is a flat, monthly rate due at the first lesson of each month. Students receive 33 lessons from September-May.

2017-2018 Rates (September-May):
30-minute lesson $936/year=$104/month
45-minute lesson $1404/year=$156/month
60-minute lesson $1872/year=$208/month

Lesson Time Request
Lesson times are for the duration of the year (September-May). If a time absolutely must be changed mid-year please give both the requested days/times and the exact dates for each time.

**Times will be assigned as closely as possible to your time request**

Lesson length
Lesson length
Sibling 2
Lesson length
Sibling 3
First Choice
First Choice Time Preference
Your answer
Second Choice
Second Choice Time Preference
Your answer
Holiday Music
Please select the holiday music your child would like to play (any/all):
Additional Info
Your answer
Studio Policies
Please view the complete policy in the 'Studio News' section of the website (log in via HixsonPiano.com).

A few important policy notes:
- There are no guaranteed makeup lessons for student absences. Lesson times that have been cancelled will automatically become ‘open lessons’ on the calendar that other students may sign up for. Students cancelling a lesson are welcome to sign up for an open time if available.

- A $50 nonrefundable registration fee (due with September's tuition) is required to reserve a spot in the schedule. The fee is used throughout the year to cover the student's materials and sheet music.

-Tuition is due at the first lesson of each month. A late fee will be automatically applied if not paid by the due date.

-Your lesson time is reserved for you for the duration of the year. Please make every effort to make piano a priority and attend each lesson.

Policy Agreement
Required
Electronic Signature (type name)
Your answer
Photo Release
Occasionally I will publish students' photos and videos of performances to the website and studio Facebook page (www.facebook.com/hixsonpiano). Students' names will never be published.
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