Impact Music Studio
General Registration Form
Student's Name and Birthdate *
Your answer
Addtional Children and Birthdates
Your answer
Parent/Caregiver Name *
Your answer
Email *
Your answer
Address *
Your answer
Phone Number *
Your answer
Opt In to Receive Class Updates via Text *
I give permission for photos/videos to be taken of my child for use in advertising or social media. I understand that no names or identifiers will be included without permission ahead of time. *
Which class are you registering for *
Date/Time of Class (if a date and time has not been confirmed for private lessons please leave blank)
Your answer
I'm excited to get to know you and your child! Is there anything else I should be aware of such as allergies or special needs?
Your answer
Do you, your child, or any other family member have a background in music?! If so, please tell me about it
Your answer
Were you referred to Impact Music Studio by a current family? If so, please let me know so I can give them the credit they deserve!
Your answer
How would you like to pay for classes? *
General Studio Policy's
For Group Classes (including Kindermusik) with a start and end date

-$30 registration fee/family applies to new students (one-time fee)
-No Classes on Long Weekends
-50% refund will be applied for students resigning before classes begin
-No refund for classes once classes have begun
-We understand life is busy especially with children. If you have to miss a class please let us know beforehand via email (info@impactmusicyyc.com). Students are allowed up to two missed classes/ session that can be used as a credit towards next session. Families will only be credited for a maximum of 2 missed classes/ session.
-Group Classes take place at Crossings Dance Studio, please remove footwear in lobby before proceeding to studio
-If teacher has to cancel class for any reason students will receive a refund for that class

For Private on-going Classes

-$30 registration fee/family applies to new students (one-time fee)
-No Classes on Long Weekends (including Mondays)
-To cancel ongoing classes 30-days notice is required
-Automatic Payments will be taken out on the 1st business day of each month, 1st payment will be manual allowing you to input your information online in a secure manner. During first lesson we will collect Credit Card information inputting it directly into our payment software. Once inputted Credit Card number is no longer visible.
-Manual Payments will be sent an invoice on the 1st business day of each month, payment is expected within 7 days
-Teacher Cancellations: If teacher has to cancel the lesson for any reason, they may attempt to reschedule when possible, if not possible student will receive a credit towards their next month
-Student Cancellations: For over 48 hours notice students will either be rescheduled or receive a credit towards their next month. Less than 48 hours notice will result in either a reschedule or a "sick day" credit (students get 3 sick credits/ year. After 3 "sick days" reschedule will be attempted but, not guaranteed and families will forfeit the lessons cost)
I have read and understood the studio policies listed above and agree to the terms *
Thanks for registering!
Registration will be confirmed within 24 hours once payment is received.

If choosing Automatic payments you will be charged for your first month of lessons plus registration fee (if you are a new family with Impact Music Studio) and will receive invoice/receipt/confirmation via email

If choosing Manual Payments you will receive an invoice within 24 hours of filling out the registration form. At this time, you can follow the link to pay via credit card or ignore the link and send an e-transfer to info@impactmusicyyc.com. You will receive a confirmation of payment being made and receipt via email.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy