Student Name *
Student Name
Parent/Guardian
Parent/Guardian
Applicable only to students under the age of 18.
Phone *
Phone
Best phone number to contact the customer.
Instrument
Please select the instrument of study.
Lesson Location *
Please choose the best location for your lesson. Students not enrolled at Memorial or Brazoswood High Schools are not eligible to receive lessons at those locations.
Please provide several. Lessons are available during lunches and off periods as well.
For students enrolled in choir at Brazoswood HS, Memorial HS, and Lake Jackson Intermediate, please enter their choir period. If not applicable, type "n/a."
DESIRED METHOD OF PAYMENT
As the legal guardian of the student listed on this registration form, I hereby acknowledge and agree, by checking this box, to fully abide by the terms and conditions outlined within the "Tuition & Policies" page of the Bayou City School of Music webiste. Failure to abide by these policies will result in the termination of lessons and no refund for a given month of lessons. PLEASE MAKE SURE TO CAREFULLY READ "Tuition & Policies" before signing this document. *
PARENT OR LEGAL GUARDIAN SIGNATURE:
FOR STUDENTS WHO WISH TO MAKE A ONE TIME UP FRONT PAYMENT, PLEASE RETURN THIS FORM to Mr. johnson in the choir room and you will contacted by Mr. hearn to set-up your lesson time.