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 I am interseted in (check all that apply)

 O Summer Lessons                                    O Bass Guitar Lessons

 O Piano Lessons                                         O Mandolin Lessons

 O Six String Guitar Lessons                       O Piano Tuning Service

 O New Student               O Returning Student

Student & Contact Information

 Students Name __________________________________________

 Street Address __________________________________________     Apt/Unit# ______

 City ___________________________

 State __________________________     Zip ___________

 Home Phone ___-___-____       Cell Phone ___-___-____         Work Phone ___-___-____

 Email _____________________________

 Parents' Names (if Applicable)

 __________________________________    ________________________________

 Date of Birth __ / __ / ____

 How did you hear about KeyNote Music Studios? (please be specific)



Registration may be done in person, by phone 419-420-2738, or by emailing all of the necessary information to us.

              KeyNote Music Studio Policy

Payment for lessons is due on the first lesson of each month. A Monthly Fee is generated by the current price charged for each half-hour lesson.  Late Payments will be not be tolerated. No post-dated checks or credit card payments are accepted.

There are no refunds if you decide not to continue at our studio.  A late fee of 2% will be charged for any payment not recieved at the first lesson of each month. The Monthly Fee is considered a contract to retain the services of the Instructor the same as a school or University. There are no implied refunds

The lesson schedule will be adhered to unless it deems not to work for the student.  A new lesson schedule can be instituted but must become permanent once it is established. This will avoid confusion on the part of the instructor and the student.  There will be a 24 hour cancellation  call if the student has a  conflict  with his or her lesson schedule. Make-up lessons are given in the event the student is sick or there is a family emergency.  Four (4) make-up lessons are allowed for the year with  no make-up lessons for inclement weather, vacation or call less than 24 hours in advance to cancel. There are three (3) breaks scheduled during the year which the Instructor  is not teaching. These will vary with the School Calendar and Christmas.

Student will purchase any material required by the Instructor. All materials will be charged to the (Parent) Student used by the Instructor. Any copies provided by the Instructor are to be used for the sole purpose of instruction and a copy fee is charged only for the cost of the ink and paper used to generate the material and is in no way a copyright infringement on any Music Company, Editor or Author of such music.

This Policy is considered a CONTRACT between the Instructor and (Parent of) Student and by signing, you acknowledge and  agree to the terms stated in this policy set forth in the above..

 I agree with and will adhere to the policies of KeyNote Music Studios as stated above.

 Students signature __________________________________________

 If under 18 years of age

 Parents' signature __________________________________________       Date __ / __ / ____

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