Enrollment

IMPORTANT: Please fill out all applicable information. To complete registration, $50 enrollment/studio supply fee is required. You will be directed to our secure PayPal payment site after you complete the form. If you have not already been scheduled for your first lesson, someone will call you to schedule lessons as soon as the form is received.

Before completing application, please read our school policies. If you need help filling out the form or have question, please contact us.

Enrollment Form

Please Select One *

New Student

Returning Student

Student's Name *

Birthdate *

School *

Grade *

Parent's Name *

Address

City

State/Province

Zip/Postal

Home Phone *

Cell Phone *

Work Phone

Email Address *

When do you wish to begin lessons? *

Please choose the appropriate program: *

Guitar

Arts

Piano

Pottery

Violin

Voice

Drum

Photography

Adult Art

Preferred lesson day (1st Choice): *

Preferred lesson time (1st Choice): * :

Preferred lesson day (2nd Choice): *

Preferred lesson time (2nd Choice): * :

Do you have siblings that need to be scheduled together?

Yes

Would you like to receive statements via email? *

Yes

Would you like to sign up for our e-mail newsletter? *

Yes

Referred by:

Photo Consent *

Yes, I agree to allow Zhen Music and Arts Institute to use images and likenesses of my child in the promotional materials, website, and social media of the school.

No, I do not agree to allow Zhen Music and Arts Institute to use images and likenesses of my child in the promotional materials, website, and social media of the school.

Release *

I hereby release Zhen Music and Arts Institute Instructors from any and all liability and responsibility in connection with such activities and hereby release all parties from liability by reason of any accident or of injury suffered by said child while engaged in such activities.

Parent's Signature *

Date *

reCAPTCHA