2026-2027 Private Lesson Registration Form

2026-27 RSM Private Lesson Registration Form (1)

Step 1 of 4

Name
This field is for validation purposes and should be left unchanged.
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.

REGISTRATION and COMMITMENT: Our 37-week Academic Year 2026-27 begins Aug. 31, 2026 and ends June 12, 2027 (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 12, 2027.
Absence Policy*
I agree to the absence policy.
Each instructor reserves a weekly lesson time exclusively for their students. There are no refunds for lessons missed due to student absences, and makeup lessons are not guaranteed. This includes scheduled absences and last-minute cancellations. We ask that you contact the office if you plan to miss your lesson. If a 24-hour notice is given, a teacher may make up a lesson in person or via Zoom if there is a cancellation in their schedule. No more than two makeup lessons will be offered for the academic year. No makeup lessons will be offered after the end of the academic year, June 12th. Please note, makeup lessons may be shorter than the student’s regular scheduled lesson. In the case of teacher’s absence, the teacher will arrange a makeup lesson, or a substitute may be provided. Students are not permitted to transfer minutes from their lesson to a sibling or friend. For inclement weather, see our website for cancellations. If students are experiencing sickness, they should not attend class in-person and should contact the RSM office as soon as possible. An online session may be offered instead.
Student Name*
First Last
Is Student a Current or New/Returnng Student?*
- Current Student (no updates to email, phone number or address)
- Current Student (email, phone number or address updates)
- New or Returning Student
A non-refundable $35 registration fee is due upon registration for all students. This fee will be waived for current students who remain enrolled, without taking a break longer than one month, including during the summer session.
A non-refundable $35 registration fee is due upon registration for all students. This fee will be waived for current students who remain enrolled, without taking a break longer than one month, including during the summer session.
Phone Number to Update
If parent or guardian is updating the phone number, please indicate your name.
Email to Update

If parent or guardian is updating the phone number, please indicate your name.
Address to Update
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student's Birthdate*
MM
DD
YYYY
Student Age*
School and Grade
Student Email
Enter Email Confirm Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student Home 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 Information
All information will remain confidential. Please tell us about any medical physical, or other concerns that may affect the applicant's participation in RSM programs.

Choose Desired Payment Plan*
- PLAN A: Payment in full. (minimum of 4 months)
- PLAN B: Monthly payment.
AutoPay is required for private lessons. An up-to-date credit or debit card is required and will be charged on the 1st of each month. A $10 fee will be charged for credit or debit cards that are unable to be processed. 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.
PLAN A: Full payment is due at the time of registration. A 5% discount is given for Plan A registration received through December 19, 2026 for first installment and through June 12, 2027 for second installment through our recurring payment system. Tuition will not be prorated or credited for planned or unplanned missed lessons (must pay a minimum of four months).
PLAN B: Tuition balance will be paid monthly through our recurring payment system. Monthly tuition will not be prorated or credited for planned or unplanned missed lessons.
Parent / Caregiver Responsibility*
I agree to the parent/caregiver responsibility policy.
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.
Cancellation*
I agree to the cancellation policy.
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.
Declaration*
I agree to the following declaration policy.
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 2026-2027 parent/student handbook.
Printed Name*
Please provide the name of the person completing the form.