PRIVATE GUITAR/VOICE/SINGER-SONGWRITER LESSONS REGISTRATION

Student Type:^*

Adult
Child

Student First Name^*

Student Last Name^*

Student Address^*

Address Line 1 ^*

Address Line 2

City ^*

State or Region ^*

Zip ^*

What is the preferred email address to receive HeartStrings communication?^*

Student Email

Home Phone

Mobile Phone

Student Gender

Male
Female

Student Birthday^*

Parent First Name

Parent Last Name

Parent Address (Skip if registering as an adult OR if same address as above)

Address Line 1

Address Line 2

City

State or Region

Country

Zip

How did you hear about us?^*

If referred by a friend, please enter their name so that they may receive their referral discount.

Who will be the primary practice parent/contact?^*

Current musical groups or orchestras you'll be with this year:

School Music Teacher

Grade^*

Session Selection(s)/Skill Level^*

Kid's Guitar/Voice/Singer-Songwriter - Level 1 - 30 min (37 lessons @ $40 ea.)
Kid's Guitar/Voice/Singer-Songwriter - Level 2 - 45 min (37 lessons @ $60 ea.)
Kid's Guitar/Voice/Singer-Songwriter - Level 3 - 60 min (37 lessons @ $80 ea.)
Adult's Guitar/Voice/Singer-Songwriter Lessons - All levels - 60 min (37 lessons yearly @ $80 ea.)

Choose your preferred way to pay tuition (Following registration, an email will be sent detailing your rate and payment plan.)^*

Monthly recurring automatic charge for 12 months
Quarterly recurring automatic charge Sept. 1, Dec. 1, Mar. 1, June 1
Biannual recurring automatic charge on Sept. 1 and Mar. 1
Pay in one installment for the year at time of registration

We offer $20 off yearly tuition for using a bank account to make tuition payments rather than a credit card! Are you interested in receiving this discount?

HeartStrings Parent's Guide & Policies (Click link at top of page to view)^*

I have read the full "HeartStrings Academy Parent Guide & Policies"

I agree

Payment Agreement^*

I authorize HeartStrings Academy to initiate electronic debit entries for payment of tuition from my chosen credit/debit card or bank account. I understand my account will be set up for automatic tuition drafts based on the payment option selected. I understand that I may quit at anytime, but there will be no refunds for auto debits already made.

I agree

Missed Lesson Policy^*

I understand the missed lesson policy and will refer to it when lessons are missed to determine allowed options.

I agree

Would you like to make your contact information available to other HeartStrings students/parents solely for the purpose of lesson swapping?^*

I give HeartStrings Academy permission to use photographs taken during classes/jam parties for promotional purposes. Photos may be used in newspapers, marketing, website, social media, etc.^*

PRIVATE GUITAR/VOICE/SINGER-SONGWRITER LESSONS REGISTRATION

Register on the form below after reading our “HeartStrings Academy Parent Guide & Policies” (Click to view.)

Yearly tuition for Kids includes 37 lessons. 32 of the lessons will be regularly scheduled and 5 lessons will be “Flex.” The schedule can always be viewed on our website calendar here.

A $100 one-time administrative fee is due at time of registration. You will be redirected to a secure payment page upon completion of this form. Registration is not accepted without payment of the initial fee.

HeartStrings Alexandria

HeartStrings Lewisburg

HeartStrings Beckley

PRIVATE GUITAR/VOICE/SINGER-SONGWRITER LESSONS REGISTRATION

Share

Register on the form below after reading our “HeartStrings Academy Parent Guide & Policies” (Click to view.)

Yearly tuition for Kids includes 37 lessons. 32 of the lessons will be regularly scheduled and 5 lessons will be “Flex.” The schedule can always be viewed on our website calendar here.

A $100 one-time administrative fee is due at time of registration. You will be redirected to a secure payment page upon completion of this form. Registration is not accepted without payment of the initial fee.

Share

HeartStrings Alexandria

HeartStrings Lewisburg

HeartStrings Beckley