New Student Registration Form
Name_____________________ ______________________________ __________
First Last M.I
Address__________________________________ _________
Street apt.#
__________________________________ _________ ____________
City State Zip Code
Phone #_____________________ _____________________ _____________________
Work Home Cell
Email_____________________________ Birthday________ _________ _________
Month Day Year
Class Registering For_____________________________________________________
Date of First Class________ _________ _________ Class Time_____________
Month Day Year
Day of Class:(Circle one) Monday Tuesday Wednesday Thursday Friday Saturday
How Did You Hear Of Muse for Life?__________________________________
______________________________________________________________________________
Contract: I understand that the charge for registration is $20, and that this $20 registration fee is non-refundable under any circumstances. I also understand that Muse for Life requires a 30 day notice from the first of the month in order to discontinue lessons, and, therefore, Muse for Life will not be accountable for any discontinuation of payment collection unless this notice has been given. I understand that the time which I have registered for is the only time which Muse for Life is accountable for services during, but I also understand that circumstantial adjustments to this time can be made at the front desk, and that Muse for Life will honor such adjustments as long as they are communicated and rescheduled at least 24 hours prior to the original scheduled time. I also understand that under no circumstances is Muse for Life responsible for giving services for lesson times which were missed without notice or cancelled late. All cancellations must occur at least 24 hours prior to the scheduled lesson time in order to be honored for make-up. Finally, I understand that all payments are due for collection on the first day of each month, and that the monthly payment includes one lesson charge for each time the sheduled lesson day occcurs within that month.
_______________________________ ____________
Signature of Student or Student Guardian Date
____________________________________________________________________________________________
For Office Use Only: Registration fee received- Yes No Date received_________ _____ ______
Authorized Signature___________________________________ Month Day Year