Boulevard Music Lessons Online Registration

Registration

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Welcome to Boulevard Music Lessons online registration! Please provide your information below and click submit when complete. Please note a $25 registration fee is required at sign up.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

We offer lessons in all instruments and voice for any age or skill level!

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

We offer lessons in all instruments and voice for any age or skill level!

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

We offer lessons in all instruments and voice for any age or skill level!

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

We offer lessons in all instruments and voice for any age or skill level!

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

We offer lessons in all instruments and voice for any age or skill level!

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Payment Policy

Tuition is $109 per month for 30 minute lessons, per student. (Tuition will be adjusted at the discretion of Boulevard Music Lessons if multiple students are enrolled or if students are enrolled in multiple classes.)

There is a one time registration fee of $30 per student due at the time of registration.

First month's payment is due at the time of registration.

Payment is made directly to Boulevard Music Lessons via credit/debit card or electronic check and always deducted within 3 days of your billing date.

A fee of $15 will be added to your account balance if it is not in good standing within 3 days of your billing date.

Boulevard Music Lessons reserves the right to to remove the student from the schedule and collect any fees associated to late payment.

Cash payments are not accepted.

I've read the above and agree.

Makeup Policy

Students are always offered four lessons per month, if there are five weeks in the month you will receive an extra lesson at no charge.

Boulevard Music Lessons offers one makeup per month due to absence.

24 hour notice is required to be eligible for a makeup lesson.

Extenuating circumstances related to absences, it is at the discretion of Boulevard Music and our teachers to offer more than one makeup per month.

Holidays that fall on lesson days or any cancellations due to extreme weather are only rescheduled if students are not receiving the minimum of four lessons.

Boulevard Music Lessons reserves the right to remove any student from our schedule due to multiple absences. To avoid this please contact the studio as soon as possible with any scheduling conflicts.

A minimum of three days notice prior to billing is required if for any reason you decide to take a break from lessons.

Boulevard Music Lessons reserves the right to charge $25 to any account who does not give proper notice of stopping lessons.

I've read the above and agree.

Student Conduct Policy

At Boulevard Music Lessons' discretion, students under the age of 12 must be accompanied by an adult, this includes dropping them off and picking them up for lessons.

No children under the age of 12 are to be left unattended in the waiting area.

It is at the teacher's discretion to end any lesson early due to student's misbehavior.

Any student arriving 15 minutes or more late to their scheduled lesson time will not be given a lesson unless scheduled through the studio prior to their arrival.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Please fill out ONE of the following Payment Methods

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number