Boroughbridge Academy of Music:          Lesson Request Form
Thank you for choosing Boroughbridge Academy of Music as your provider of music tuition. We are delighted to welcome you onboard! In order for us to schedule your lessons, we ask that this form is fully completed. 
We look forward to meeting you soon!
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Email *
Name of Student *
Date of Birth of Student *
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/
DD
/
YYYY
Home Address (including postcode) *
Parent name (if under 18)
Please type N/A if not applicable
*
Contact Mobile Number *
Which Instrument are you requesting lessons for? *
Please select the length of the lesson you wish to have *
Please select your experience on this instrument *
Have you taken any examinations on your instrument? If so - please comment here. If not, please write N/A *
We offer lessons at various time throughout the day. Please select your availability from below. *
10:00 - 15:30
15:30 - 19:00
Not Available
Monday
Tuesday
Wednesday
Thursday
Friday
First Aid and Medical
If the student has any known medical conditions or allergies that we need to be aware of, please list below:
Pre-existing medical conditions:
Please type N/A if not applicable
*
Pre-existing allergies:
Please type N/A if not applicable
*
Emergency Contact Name: *
Emergency Contact Mobile Phone Number: *
Terms and Conditions
Before pressing submit, please confirm you have read the terms and conditions below:
Our lessons run all year round with a two week break at Christmas and a two week break in the summer holiday for our summer school. We will be closed for 3 additional weeks during the year where our teachers will take their annual holidays (these will be in term time avoiding the weeks leading up to private examinations). 

Lessons are invoiced in monthly blocks and must be paid in full prior to the first lesson of each block. Invoices will be sent to the email address you have provided above, so please ensure if there any changes that we are kept fully informed. Failure to make this payment by the payment date may result in additional fees and / or loss of place in the Academy.

With the exception of Piano / Keyboard - it is expected that all students will provide their own instrument in full working condition for their lesson. If you do not have an instrument, we recommend getting in touch with Windstruments (01274 510050) who are our main supplier of Woodwind instruments. We stock a selection of reeds which can be purchased from your teacher. 

If a student misses a lesson, the fee for that lesson will still be charged unless at least 24 hours advanced notice of the absence has been given via email to boroughbridgemusic@gmail.com. If the teacher cancels the lesson due to illness, the lesson will be either be re-arranged or credited to the following block of lessons.

Four lessons notice (or equal pay) in writing to boroughbridgemusic@gmail.com is required for
termination of tuition. This enables us to rearrange teaching schedules and organise new students from waiting lists.

All fees are reviewed on an annual basis. 

I confirm I have read the terms and conditions above and by clicking submit agree to them *
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