2019-2020 Registration Form 2019-20 RSM Private Lesson Registration Form Step 1 of 3 33% PROGRAM DESCRIPTION - Our music instruction focuses on developing a well-rounded musician. All private lesson students have the option to participate in enhancement activities, which includes student recitals (four per year), honors performance, musicianship classes, master classes, nursing home performances, community performances, competitions, county music exams and festivals. Photos and videos may be taken of students and parents at these special events and posted periodically on our website and social media with no names attached. REGISTRATION and COMMITMENT: Our 37-week Academic Year 2019-20 begins Sept. 4, 2019 and ends June 13, 2020 (please see our handbook for more details). The academic calendar can also be viewed on our website. Students may start our program at any time during the year. Upon registration, students commit to the program through June 13, 2019. Student Name First Last Student Age*Please enter a number from 3 to 100.School and Grade*Student Email* Enter Email Confirm Email Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Student Phone Number*Parent / Guardian Name (1)* First Last Parent / Guardian Email (1)* Enter Email Confirm Email Parent / Guardian Phone (1)*Parent / Guardian Name (2) First Last Parent / Guardian Email (2) Enter Email Confirm Email Parent / Guardian Phone (2)Emergency InformationAll information will remain confidential. Please tell us about any medical physical, or other concerns that may affect the applicant's participation in RSM programs. Instrument(s) of Study*Please provide the instrument(s) the student will study.Lesson Length*30 minutes: $35.0045 minutes: $52.5060 minutes: $70.00Please provide lesson length. Application fee: $32 for non RSM students.Lesson Time*Please provide 3 days and/or times you prefer to have your lesson (list in preferred order).Recitals December 21 March 14 June 13 Students participating in recitals must pay a $20 Recital Fee for each recital to be billed the month before each recital (i.e. Dec. 21st recital fee will be due Nov 1st). No late recital fees will be accepted. Fees are non-refundable or transferable. Students will select the recital(s) in which they want to perform. All recitals are held between the hours of 12:00 pm - 4:30 pm at the Slayton House. Attendance is free for parents and guests. If student is unable to participate in a recital during certain hours, RSM must be notified at least 4 weeks before each scheduled recital. Requests given less than 4 weeks before recitals will not be honored.Optional: Fall Musicianship Classes* Tuesdays 6:00-6:45 pm (young musicians) Saturdays 10:00-10:45 am (older musicians) Prefer not to participate in musicianship class Musicianship classes present master classes as well as focus on theory, ear training and performance practice techniques. 65 fee for Fall Session classes due by Sept 17th. Classes begin Sept 24th thru Dec 7th (10 classes). No refund after the first class begins. Select a class to attend below.Optional: Spring Musicianship Clases* Tuesdays 6:00 - 6:45 pm (young musicians) Saturdays 10:00 - 10:45 am (older musicians) Prefer not to participate in musicianship class Musicianship classes present master classes as well as focus on theory, ear training and performance practice techniques. $65 fee for Spring Session classes due by Jan 1st. Classes begin Jan 7th thru Mar 14th (10 classes). No refund after the first class begins. Select a class to attend below. PLAN A: Payment in full. Full payment is due at the time of registration. A 5% discount is given for Plan A registration received through December 21, 2019 for first installment and June 13, 2020 for second installment. Tuition will not be prorated or credited for planned or unplanned missed lessons (must pay a minimum of four months). PLAN B: Monthly payment. Tuition balance will be paid in equal installments to be received no later than the first day of each month with credit card, cash, or check. Tuition may be paid online, mailed, placed in drop box, or through our recurring payment system. Monthly tuition will not be prorated or credited for planned or unplanned missed lessons. Choose Desired Payment Plan*Plan APlan BLate Fee*Tuition is due the first of the month. If tuition is late, student will not be permitted to receive lessons unless tuition is received 24 hours before lessons begin. If tuition is not received by the third of the month, a $25 late fee will be applied to student’s tuition. No make-up will be given for this missed lesson. If tuition is not received by the 14th day of the month, student will be withdrawn from RSM. Note: A $35 fee will be charged for checks or credit cards that are unable to be processed. (Initial to accept terms.) * Billing Method*Email Monthly InvoicesRecurring Payments (fill our required form at RSM)Monthly invoices will be emailed if recurring payment is not preferred. Select the method you prefer: * Invoice Email Address* Enter Email Confirm Email Make Up Lesson Policy*PLEASE NOTE: Due to limited availability on teacher's schedule, students will be given a total of (2) two make-up lessons at no additional cost for the academic year for any absences if a 24-hour notice is given. Makeup lessons will not be given for any reason if a 24-hour notice is not given. This includes last minute cancellations for sickness and traffic as teacher needs adequate time of notification and must be compensated for their time. Once students have received their two makeups for the academic year, no other makeups will be provided. Students will be notified once they have reached their maximum makeup quota for the year. All makeup lessons must be completed by June 13th. After June 13th, any incomplete lessons will be forfeited. In case of inclement weather, emergency closure or administration leave lessons will be rescheduled for an alternate day. Please see our handbook for more details.Parent / Caregiver Responsibility*Parents/Caregivers should be on time to pick up their child/children once lessons or classes have ended. Parents/Caregivers are financially responsible for any damages to RSM’s materials, equipment or property incurred by their children. (Initial to accept terms.) Cancellation*Two-week written notice must be given to the RSM Office for lesson termination. RSM reserves the right to terminate lessons for non-payment of tuition. (Initial to accept terms.) Declaration* I have indicated my chosen tuition payment plan and billing method on this form. I agree with the contents and policies of this registration form, photo/imaging guidelines and the 2019-2020 parent/student handbook. (To authorize and accept, please initial and date.)Printed Name*Please provide the name of the person completing the form.Comments or QuestionsNameThis field is for validation purposes and should be left unchanged.