Backbeat Music Academy Registration Form
Please fill out this form. We'll use the information to know how to contact you and to get to know the student better.
Student's Name(s) *
Your answer
Musical Experience, if Any
Your answer
What instruments / bands are you interested in? (mark all that apply) *
Required
Any special considerations about the student
Your answer
Other Comments
Your answer
What are your scheduling considerations? When is the best time for you, when are acceptable times and when is not possible?
Your answer
Age (write zero if you prefer not to share) *
Your answer
Birth Date (we like to say Happy Birthday)
MM
/
DD
/
YYYY
Parent/Guardian names
Your answer
Address *
Your answer
Phone Number(s) and who they belong to *
Your answer
Do you do text messages?
Email *
Your answer
Photos, videos and audio recordings are educational tools employed by Backbeat to show students what they are doing. I also understand that Backbeat may want to use some of these images in social media, their website, or in another capacity if they are doing great and those images are worth sharing. Some of these images will be done with fully professional equipment and any images will be given to me. *
Emergency Contact
Your answer
How did you hear about us?
I understand that Backbeat Music charges monthly, and this covers 4-5 lessons each month. Tuition is due at the beginning of each month. *
Required
I understand that Backbeat Music requires 24 hour notice of cancellations. We'll always try to reschedule lessons whenever mutually convenient but the teachers get paid for their time whether the student is there or not. Band classes and group classes aren't reschedulable or make-upable due to schedule complexity of all the students involved. *
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