Lesson Enrollment Secure Form

* * PLEASE NOTE: In-Person lessons are ONLY held in our store at 6101 Burnet Rd, Austin, TX * *

Please choose a lesson type: *

Adult Piano (ages 18-99)

Adult Drums (ages 18-99)

Child Piano (ages 5-17)

Child Drums (ages 5-17)

Student Name *

Birthday *

School *

Grade

Address *

City *

State *

Zip *

Home Phone (if actually used)

Cell Phone *

Email *

Parents: Same household? *

Yes

No

Not Applicable - I am an Adult Student (put n/a in Parent 1 & 2 section)

Parent 1 *

Phone 1 *

Phone 2

Parent 2

Phone 1

Phone 2

Emergency Contact (not spouse) *

Phone *

How did you hear about us? *

FEES AND PAYMENTS

Monthly auto-charge ATM/credit/debit or check card required to be on file for materials/tuition/tutor payments. Nothing will be charged to your credit card until the lesson time is scheduled.

Registration Fee: $35.00 ($10 each additional family member).

Materials Fee: Music books and materials are selected and charged as students progress.
Monthly Tuition: $180 for 30 minute weekly lesson, $260 for 45 minute, $340 for 60 minute.

Tuition discounts available:

a) $10 off with rental or purchase from CapMusic of a Teacher Preferred Roland Piano or a Teacher Preferred Roland V-Drum Set

b) $5 off with rental or purchase of any piano or drumset from CapMusic

c) $5 off for each additional same household family member (cannot combine with other discounts)

d) partner or group lessons (click HERE for rates)

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Initials

REQUIRED EQUIPMENT

-For PIANO Lessons: An 88-key piano in full working order with fully weighted hammer action and 3 pedals, preferably digital. (click here for recommendations)

Note 1: Digital pianos weighing less than 50 pounds do not qualify because they physically cannot have a fully weighted hammer action.

Note 2: Acoustic pianos must be able to be tuned to pitch, and be tuned every 6 months.

-For DRUM Lessons: A drum set, preferably digital, in full working order. (click here for recommendations)

-Technology Practice Partner: an iPad, a Roland Piano with a USB Flash Drive port, a Roland V-Drums with a USB Flash Drive port, or a Roland Music Tutor is needed to help in-home practice and success. If you don't have any of these, then you will need to rent a Roland Music Tutor from us for $3 per month.

Please indicate what you have: *

Brand & Model

Age

LESSON SCHEDULING

Please select your teacher preference: *

Please indicate what type of lessons you are interested in: *

Please select all available times for lessons:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Other considerations for scheduling, level, particular learning goals:

LESSON POLICIES

INITIAL ENROLLMENT COMMITMENT:

We are a year-round education program with special options available for the summer months.

-For Minor Students: Parents & Student agree to a minimum 4 month or semester's commitment. Withdrawal from lessons simply requires a 30-day written notice.

-For Adult Students: I agree to try lessons for at least 1 month. Withdrawal from lessons simply requires a 30-day written notice.

-For Group Students: I agree to commit my child to group lessons for the remainder of the school year (May 31). {Exception: You may give notice by Dec 1 to drop the upcoming Spring Semester (Jan-May)}.

Benefits of staying with us through the summer months:

-We offer a variety of flexible camp and lesson combinations to work around vacation schedules and holidays

-Students better retain what they've learned

-Annual registration is waived

-Get higher fall scheduling priority

-Retain their preferred teacher

-Get a bonus summer lesson if you choose Best Value summer option

HOLIDAYS:

-We follow the AISD calendar for Thanksgiving, Christmas, Spring Break, Labor Day, Memorial Day, and 4^th of July.

-Classes are still held on President’s Day, MLK Day, Columbus Day, and Veteran’s Day.

CANCELLATION:

To be fair to both teacher and student, we require a 30-day notice via our Exit Form to discontinue lessons after the initial commitment period. To resume lessons, student would re-register at the new tuition rate and pay a new registration fee.

ABSENCES:

-Regular attendance is necessary for musical growth.

-Makeups for absences (illness, travel, choice, etc) are not available due to teachers’ schedules. Please contact teacher for missed assignments.

-Teacher absences will be made up or a credit in tuition will be applied.

TUITION PAYMENTS:

-Monthly tuition is a flat fee based on minimum of 46 lessons per year plus 2 performance opportunities.

-Number of lessons per month will vary according to calendar.

-Tuition is due the 1st of each month.

-Late fees will be charged for late payments.

RECITALS:

-Capital Music Center holds recitals at the end of the Fall and Spring semesters.

-The recital is included in the tuition as the last class of each semester.

PARENTAL SUPERVISION:

I understand that Capital Music Center is not responsible for any unattended children before, during, or after lessons. If I choose to drop off my child for their lesson, I will be at the store/school promptly at the end of the lesson to pick up the child. I will ensure that any children under my care are supervised at all times. I understand that I am permitted to watch my child's lesson if I so choose.

Participation in our program permits us to take photographs, and make audio or video recordings of students for the purposes of advertising, promoting and increasing awareness of our lesson program, and for you to share with family and friends. Capital Music Center will own the copyright of such photographs and audio and video recordings and as such may publish the same in any medium.

I acknowledge the terms and receipt of this agreement.

Initials *

Date *

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