Trial Lesson Form

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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 minutes: $35.00
- 45 minutes: $52.50
- 60 minutes: $70.00
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*
PLEASE NOTE: No refund or reschedule for trial lesson unless a 24-hour notice is given.
(Initial to accept terms.) *
Invoice Email Address*
Payment is due once application is received. An invoice will be emailed to you. Provide the email address you would like the invoice emailed.
Enter Email Confirm Email
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.)
Declaration*
I agree with the contents and policies of this trial lesson form. (To authorize and accept, please initial and date.)
Printed Name*
Please provide the name of the person completing the form.
Comments or Questions
Email
This field is for validation purposes and should be left unchanged.