Trial Lesson Form

TRIAL LESSON - New students interested in enrolling in music lessons have the option to sign up for a trial lesson.
Student Name
First Last
Student Age*
School and Grade*
Student Email*
Enter Email Confirm Email
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)

Instrument(s) of Study*

Please provide the instrument(s) the student will study.
Trial Lesson Length*
- 30 Minute Trial: $39.00
- 45 Minute Trial: $58.50
- 60 Minute Trial: $78.00
Please provide the trial lesson length you prefer.
Date and Time of Trial Lesson*
Please provide the day and time you would like to have your lesson.
Music Experience*
Has the student previously taken lessons on the instrument desired? If yes, please explain.

Cancelation Policy - 24 Hour Notice Required*
I agree to the cancellation policy.
PLEASE NOTE: No refund or reschedule for trial lesson unless a 24-hour notice is given.
Parent / Caregiver Responsibility Policy*
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.
Declaration*
I agree with the contents and policies of this trial lesson form.
Printed Name*
Please provide the name of the person completing the form.
Comments or Questions
Total Amount Due
$0.00
Name
This field is for validation purposes and should be left unchanged.