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Above address same as billing?If not fill out below

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Sex

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Instruments
I am registering for:
Private Lessons Location
Instrument choice for private lessons
Membership Agreement & Policies


• Each student must sign off to have a card on file and agree to be drafted each

month on the 1st.

• All lesson fees will be drafted on the 1st of each month.

• During months with holidays, the lessons must be made up if the student

chooses to cancel. (Lessons will not be prorated)

• Lessons must be rescheduled, or the student forfeits the lesson fee.

• The make-up lesson must take place within the month of the missed lesson.

• If the instructor is unavailable for the makeup lesson, the lesson fee will not be

refunded.

• If the instructor needs to cancel, the lesson will be made up, or the fee will be

refunded.

• If a student knows they will miss a certain number of lessons during a month,

you must notify before the 1st to be considered to be prorated.

• No-shows will not be refunded/rescheduled.

• If a student is more than 15 minutes late, they will be considered a no-show,

and teachers will not be required to stay for the remainder of the lesson time.

• If the student wants to cancel lessons, you must cancel before the beginning of

a new month, or you will be responsible for the entire month’s fees. No

remaining lessons will be refunded.

For the band class, there is no proration for missed classes or holidays

In-Studio Lesson Prices:

30 min lesson $30

45 min lesson $40

60 min lesson $50

In-Home Lesson Prices:

30 min lesson $40

45 min lesson $50

60 min lesson $60

Band Class:

$95 a month

$65 a month for each additional child


Annual Registration Fee

New Students:
$35
$15 for each additional child

Returning Students:
$25
$10 for each additional child


Do you agree to the above Policy?
Autopay

Debit/Credit Card Authorization – Debit/Credit Card Payments – 


*All Debit Cards will process as a credit card*


I authorize DFW Music Academy to perform scheduled or periodic electronic funds transfer debits and/or credits from my account identified below for payments due or when applicable, apply electronic funds transfer credits to the same. I understand the dollar amount can vary depending on services performed. Monthly lesson payments will be transferred on the 1st of every month.  **I agree that if my balance is not paid in full by the end of the year, that DFWMA has the authority to put my remaining balance due on the credit card below.

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