Daniels Music Studio
2022/2023 Registration
Fill out the registration below & return with payment.
Name __________________________________Birthdate (month & day) _____________
Mailing Address ____________________________ City____________________ State_____ Zip ________
Emergency Contact (name, relation & phone)__________________________________________________
Check ONE payment option: ___ Year (Sept.-June) __ Year (Jan.-June) __ A La Carte __Monthly
*if you choose monthly, 2 payments are required with registration which is for your 1st & last month of lessons --- this does NOT go towards 2 consecutive lessons
Check days & times that work for you
__Mondays __Tuesdays __Wednesdays: __6 pm __7 pm __ 8 pm
Do you plan on registering for 2023 Summer Lessons? ___Yes ___No
Check days & times that works for you
__Mondays __Tuesdays __Wednesdays __Thursdays: __6 pm __7 pm __ 8 pm
Do you plan on registering for 2023 Summer Lessons? ___Yes ___No
Acknowledgment of Studio Policies
By signing below, we acknowledge we have read and agreed to the policies established by Daniels Music Studio / Nikkol Daniels and that they are not liable for injuries sustained on, in or around the premises. We understand that failing to follow these policies will limit our success and end our association with Daniels Music Studio. We acknowledge our financial responsibilities to Daniels Music Studio and acknowledge that our tuition is non-refundable and private make up lessons are not guaranteed. We __give __ do not give permission for the above-mentioned student's picture and/or video to be taken for promotional use, studio website, music association website and/or programs used only by the studio and music teacher. This authorization __includes __does not include to utilize my child's name in conjunction with photographs &/or videotape.
________________________________
Student Signature & Date
2022/2023 Registration
Fill out the registration below & return with payment.
Name __________________________________Birthdate (month & day) _____________
Mailing Address ____________________________ City____________________ State_____ Zip ________
Emergency Contact (name, relation & phone)__________________________________________________
Check ONE payment option: ___ Year (Sept.-June) __ Year (Jan.-June) __ A La Carte __Monthly
*if you choose monthly, 2 payments are required with registration which is for your 1st & last month of lessons --- this does NOT go towards 2 consecutive lessons
Check days & times that work for you
__Mondays __Tuesdays __Wednesdays: __6 pm __7 pm __ 8 pm
Do you plan on registering for 2023 Summer Lessons? ___Yes ___No
Check days & times that works for you
__Mondays __Tuesdays __Wednesdays __Thursdays: __6 pm __7 pm __ 8 pm
Do you plan on registering for 2023 Summer Lessons? ___Yes ___No
Acknowledgment of Studio Policies
By signing below, we acknowledge we have read and agreed to the policies established by Daniels Music Studio / Nikkol Daniels and that they are not liable for injuries sustained on, in or around the premises. We understand that failing to follow these policies will limit our success and end our association with Daniels Music Studio. We acknowledge our financial responsibilities to Daniels Music Studio and acknowledge that our tuition is non-refundable and private make up lessons are not guaranteed. We __give __ do not give permission for the above-mentioned student's picture and/or video to be taken for promotional use, studio website, music association website and/or programs used only by the studio and music teacher. This authorization __includes __does not include to utilize my child's name in conjunction with photographs &/or videotape.
________________________________
Student Signature & Date