1-on-3 Piano Lesson Student Registration Form
Dr. Wang Music Studio https://drwangmusic.wix.com/home/


Tuition is due upon registration. Only registered students can come to class. 
No refunds/credits will be given.

3 week session: $120

Payment to Ching-Yi Wang via Zelle(530-665-9321) or Venmo @Chingyi-Wang-1. Please include the student's name in the memo.  


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Email *
Class Schedule
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Student Name *
Date of Birth *
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/
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/
YYYY
Academic Grade
Please Describe Your Child's Personality
 *
Parents/Guardian Name #1 *
Parents/Guardian Email Address #1 *
Parents/Guardian Cell Phone Number #1 *
Parents/Guardian Name #2 *
Parents/Guardian Email Address #2 *
Parents/Guardian Cell Phone Number #2 *
Parents/Guardian Address *
Emergency Contact and Phone Numbers (if parents not reached) *
Dr. Wang Music Studio Policy

Etiquette
No playing and eating in the studio. Respect our Studio equipment at all times. 

Pick-Up and Drop-Off
For safety reasons, please drop off and pick up your child on time. 

Covid-19 Safety
Please do not attend class if you experience any symptom of illness. Please contact the Studio immediately if you have Covid-19. 

Student Contact Info
If there is any change in your email address or any contact info, please notify us at your earliest convenience.
 *
Required
Thank you!! 

We look forward to welcoming you. 

If you have any questions, please email drwangmusic@gmail.com or call the studio at (530) 665-9321.
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