Parent Name *

First Name

Last Name

Student's Name *

First Name

Last Name

Student's DOB *

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DD

YYYY

Sibling's Name

If enrolling more than one child.

First Name

Last Name

Sibling's DOB

If enrolling more than one child

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DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone *

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New or Re-enrolled Student *

New Student

Current Student

1. Tuition Options *FOR GROUP CLASS ONLY*

Select your tuition plan, if private lesson skip to #4.

Semester Payment (Sept. - Jan.) (Feb. - June)

Yearly Payment ($100 Discount)

Music Friends (10 Class Cycle)

2. Group Class you are Enrolling For:

Music Wonderland (Ages 3-3.5)

Junior Music Course (Ages 4-5)

Young Musicians Course (Ages 6-7)

Music Friends Class (Ages 7+)

4. Private Lesson Options

(For Private lessons Only)

30 Minutes

45 Minutes

60 Minutes

6. Private Lesson Payment Options

Monthly Payments

Checking the box below states that I will comply with all policy provisions and any breach of policy will result in interruption of student attendance. *

I have read and understand the Yamaha Music Conservatory policy for Group Class and/or Private Lessons