• Student Name * First Last
• Age *
• Instrument Type
• Parent/Guardian Name (Students under 18) First Last
• Address
• Home Phone * - ### - ### ####
• Cell Phone - ### - ### ####
• Email *
• Emergency Contact

• Please read through our policies and click submit below

• Payment Policies:
  
  • All lessons are pre-paid.
  
  • Teachers are not paid until tuition is paid. Service will be refused if tuition is not current.
  
  • Tuition is by Credit Card or Check only. (No Cash Please)
  
  • Full tuition is due by the last lesson of the month for the following month.
  
  • Tuition is one full calendar month minimum.
  

• Scheduling Policies:
  
  • We require 24 hours notice is required to reschedule a lesson.
  
  • Please fill out a schedule change request at the front desk, email, call, or submit a web form.
  
  • No show and same day cancellation will be billed and the lesson is forfeited.
  
  • Make up lessons cannot be used as credit for future lesson tuition.

• Withdrawal:
  
  Please provide 7 days notice of intent to discontinue lessons. Please fill out a withdrawal form at the front desk or at broadwaymusicacademy.com.

• Liability:
  
  The student remains the responsibility of the parent/guardian at all times.

• By signing below, I assume any risk of harm or injury which might occur to the student due to their participation in the events or activities at Broadway Music Academy. I release Broadway Music Academy from all liability, costs, and damages which might arise from participation in the events or activities. I provide my consent for Broadway Music Academy to seek emergency treatment for the student if necessary. I agree to accept financial responsibility for the costs related to this emergency treatment. *
  I have read, understand, and agree to the policies of Broadway Music Academy.
• Date / MM / DD YYYY