Registration Form & Class/Fee Schedule

Group Piano/Keyboard Classes

{Student Information}
Firstname:		Lastname:
Address:		City:
State:	Select Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip:
Home Phone:	- -
{Minor Student}
Date of Birth:	/ YYYY 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 MM 01 02 03 04 05 06 07 08 09 10 11 12 / DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	Age:
School:		Grade:
Mother's Name:		Home Phone:	- -
Work Phone:	- - ext:	Cell Phone:	- -
Email - required:
Father's Name:		Home Phone:	- -
Work Phone:	- - ext:	Cell Phone:	- -
Email - required:
{Adult Student}
Work Phone:	- - ext:	Cell Phone:	- -
Email - required:
{Additional Student Information}
What type of instrument do you have in your home? acoustic piano digital piano electronic keyboard none of the above
I found out about Bryant's Music by: Yellow Pages Website Flyer/Brochure Newspaper/Magazine Article Bryant's Music Student/Parent Other

Class/Fee Schedule [Fee includes 8 weeks tuition, registration & all required materials.]

Group Piano/Keyboard for Beginning Children (7-10 years)

Monday 6:00pm - 7:00pm       Class starts: September 12, 2011 through November 7, 2011       No class is scheduled on Monday, October 10, 2011 (Holiday)       Registration deadline: Friday, September 2, 2011       Instructor: Dorothy Critchlow       Fee: $215

Monday 6:00pm - 7:00pm       Class starts: February 27, 2012 through April 23, 2012       No class is scheduled on Monday, March 26, 2012 (Studio Closed)       Registration deadline: Friday, Februay 17, 2012       Instructor: Dorothy Critchlow       Fee: $215

Group Piano/Keyboard for Beginning Adult

Monday 7:30pm - 8:30pm       Class starts: September 12, 2011 through November 7, 2011       No class is scheduled on Monday, October 10, 2011 (Holiday)       Registration deadline: Friday, September 2, 2011       Instructor: Dorothy Critchlow       Fee: $215

Monday 7:30pm - 8:30pm       Class starts: February 27, 2012 through April 23, 2012       No class is scheduled on Monday, March 26, 2012 (Studio Closed)       Registration deadline: Friday, February 17, 2012       Instructor: Dorothy Critchlow       Fee: $215

___________________________________________________________________________________ Group Piano/Keyboard Information & Policies Registration.  Students must register and make full payment by check, money order or online with a credit/debit card for group piano/keyboard classes 10 calendar days prior to the start of each class. Make check or money order payable to: Bryant's Music. Class Cancellation.  Bryant's Music reserves the right to cancel group classes due to insufficient registration.  Each class must have at least five (5) registered students.  If the class is cancelled by Bryant's Music, a refund of all tuition and fees paid will be issued within 10 calendar days from the date of cancellation.  In the event of cancellation, registered students will be notified by email. Refunds.  No refunds will be issued to registered students before, on or after the class that you have registered for has begun.  However, substitutes are permitted upon notification in writing to Bryant's Music.     Missed Classes.  There is no reduction in fees for student missed classes.  Classes missed due to the teacher's absence or inclement weather will be rescheduled, if a substitute teacher is not available.  In the case of inclement weather, cancellation of classes will be communicated by email. Returned Checks.  If  Bryant's Music receives notice of a check being returned for any reason, you will be dropped from the class and charged the returned check fee of $35 and the registration fee of $25.    Upon submission of this Registration Form, I certify and acknowledge that I have read the financial policies, including the Missed Class Policy as stated above and clearly understand, accept, and agree to abide by the terms herein.