New Student Registration Form

Spring Semester:  Mon, Jan 30 - Tue, June 20

After submitting your registration, we will contact you regarding your lesson schedule if it has not yet been confirmed. You will then receive via email the tuition invoice for the Spring Semester. Lessons beginning after the start of the semester will receive prorated tuition. Tuition payment is due on or before the first lesson.

Please email us with any questions: hello@bergenacademy.com

Thank you!

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Student Name (First/Last) *
Instrument (if enrolling multiple instruments, please submit a separate form for each instrument.) *
Student Birthdate (Month/Day/Year) *
Parent/Guardian Name, or "Self" (Title/First/Last) *
Phone Number (*Please indicate whether cell/home number). *
Additional Phone Number(s) (Optional)
Parent/Guardian Email Address(es) *
Home Address (including zip code) *
Lesson Length *
Are you a beginner student, or do you already have experience on the instrument?
LESSON SCHEDULE:
Please list a minimum of 2 or 3 BLOCKS of time you're available (e.g. "Mon after 3:30pm, Tue or Thu before 5pm or after 6:30pm, Fri after 5pm") rather than just one specific time slot (Tue 6:30pm). The more options you give, the less delay there will be in scheduling, and the more likely you'll secure a preferred time slot.

If none of your preferred time slots are available, we will place you on a waiting list and contact you regarding alternative options.
 *
Please list days and times with CONFLICTS that must be avoided. Please be as detailed as possible. If no conflicts, write "none". *
Teacher Name (you may leave blank if you are a new student or if you prefer to be placed based on scheduling preferences)
Are you registering an additional instrument or student from the same household? (Additional registrations from the same household receive discounted tuition.)
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BAMA STUDIO POLICIES:

IMPORTANT: Please read our studio policies here: https://www.bergenacademy.com/policies

I have read and agree to all studio policies. I understand and agree to the lesson cancelation and makeup policies. I understand that:
-Any cancelations made outside of our studio policies will not be entitled to a makeup lesson
-Students are entitled to a maximum of 2 makeup lessons for the semester, only if cancelation/makeup policies are followed
-A minimum of 24 hours' notice must be given for cancelations
-Canceled makeup lessons that have already been scheduled will not be rescheduled, refunded, or credited
-There are no refunds or credits for missed or canceled lessons.

Please write your full name (First/Last) below. Your electronic signature indicates acceptance of our policies. 
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