2009-2010 Registration Form

 

 

CONTACT INFORMATION

 

Student’s Name ________________________________________ Age______________

 

Parent’s or Guardian’s name(s)____________________________________________________

 

Address______________________________________________ Postal Code_______________

 

Home phone number___________________________                                   

 

Cell phone number_____________________________

 

Work phone number_______________________________

 

E-mail address (if applicable)_____________________________________________

 

How did you hear about us?______________________________________________

 

PAYMENT INFORMATION

Lessons run all year, however the main season is September 1 to June 30 

Option #1: 5 postdated cheques covering ½ season (dated the first of each month),

or one lump sum payment.

Please check desired lesson length:

o  ½ hour lesson @$17.50 (5 postdated cheques @ $70.00 each or one lump sum payment @ $350.00)

o  ¾ hour lesson @$25.50 (5 postdated cheques @ $102.00 each or one lump sum payment @ $510.00)

o  1 hour  lesson @$33.00 (5 postdated cheques @ $132.00 each or one lump sum payment @ $660.00)

 

Option #2: Pay as you play (payment is due before each lesson)

Please check desired lesson length:

o  ½ hour lesson @$20.00/lesson

o  ¾ hour lesson @$28.00/lesson 

o  1 hour  lesson @$35.50/lesson 

 

Ø Please be advised that you are required to pay for all missed lessons, regardless of notice or reason for cancellation.

Ø Makeup lessons, if deemed necessary, will be scheduled at the convenience of the instructor.

Ø No refunds will be issued for missed lessons. There will be an additional $20.00 fee added to all NSF cheques.

I have read, understand and agree to the contents of this form.

 

 

Signature of parent, guardian or student_______________________________________Date______________________