FootNotes Studio

Registration Form

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Registration Form: Below is form to be used for Kindermusik, Intro to Piano, and Private lessons.
Cost of classes are listed and include tuition and any materials.
Payment can be made by cash or check made out to FootNotes and brought to first class. If need to make a payment plan, please contact Melissa.

Child's Full Name:

 * required

D.O.B:

 * required

Parent Name(s):

 * required

Full Address: (Include City & Zip)

 * required

Home Phone Number:

 * required

Cell/Alt Phone Number:

Email address:

 * required

Class choice (Please click on below and scroll to choose and click class):

How did you hear about FootNotes:

By filling out this form I agree to the tuition payment information listed on the schedule of classes, and attest, as a registrant, or as parent or legal guardian, the student named is physically able to participate in the FootNotes Studio programs. While participating in these activities, I hereby waive and release all claims, liabilities, actions, damages, costs or expenses of any nature whatsoever for injuries the registrant might sustain, arising out of the activities now or at any time in the future. Further, the registrant, or their parent or guardian agrees to indemnify and hold harmless FootNotes Studio, Melissa DiGrazio, and any instructors associated, from and against any and all liabilities, claims, actions, damages, costs or expenses of any nature whatsoever. By registering, I agree to the terms of this liability waiver and release. I give permission for photographs to be used for any promotional materials.