Stop Lessons Form

Lesson Discontinuation Form
Thank you for being a part of our community at Azure Violins! It has been an honor to serve you and we hope to see you again soon! Please fill out this form to submit your request for lesson discontinuation. Please carefully read and understand our lesson discontinuation procedures before digitally signing and submitting this form.
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Email *
Student Full Name *
Instrument *
Teacher Name *
Required
Final Lesson Date *
What is the last lesson the student plans on attending?
MM
/
DD
/
YYYY
Reason for Withdrawal *
Required
I am interested in continuing lessons in the future. *
If you are interested in continuing in the future, when are you thinking of starting up again?
What could we have done to better serve you here at Azure Violins? *
Additional Comments?
I would like to stay on the Azure Violins Newsletter *
I UNDERSTAND AND AGREE THAT:
If I am taking a break for any period of time, then my preferred teacher and/or time may not be available when I return, and my child (or I) may have to relearn certain concepts and techniques. I may be responsible for paying a registration fee upon my return. If I am terminating due to financial reasons or schedule conflict, then I have already discussed possible alternatives with Azure Violins staff, including possible financial aid. If I am terminating due to a staff or teacher issue, then I have already spoken to management about resolutions and/or other teachers who may be available.

Agreement *
Required
DISCONTINUATION POLICY
IMPORTANT PAYMENT INFORMATION: As per our lesson policy ( www.azureviolins.com/lessonpolicies ), to stop lessons, written notice must be given by the 15TH DAY OF THE FINAL MONTH OF LESSONS to stop tuition for the following month. If notice is given after the 15th day of the month, your account will be charged for the following month of lessons. This online form counts as written notice. No refunds, makeups, or credits are given for lessons not attended by the student.

Digital Signature *
Your full nameYour answer
A copy of your responses will be emailed to the address you provided.
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