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Class Registration
Piano Play Music

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Are you signing up an:
Online Class In Person Class
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Billing Information?:
Continuing Student(s) New Student(s)
Contact Information:*
Mother Father Guardian
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Last Name:*
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Student - 1st Child:
First Name:*
Last Name:*
Allergies?:*
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Describe:
Birthday:*
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Day and Time options:
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Class Day:*
Child 1 (Group):
$   
Do you have a Second child?
Student - 2nd Child:
First Name:*
Last Name:*
Allergies?:*
Yes No
Describe:
Birthday:*
Select Location:*
 
Day and Time options:
Select Class:*
Class Day:*
Child 2 (Group):
$   
Group Tuition and Registration are Non Refundable
Child 1 (Group):
-
Child 2 (Group):
-
Total Amount Due:*
$   
Payment Information:
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Credit Card Expiration:*
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Please read tuition policies on the back or below

I/We request Piano Play to reserve a place for my child/children for the terms of this contract. I acknowledge that Group Class Tuition is NON-REFUNDABLE. Refunds will be given only if the group class is cancelled of there is no group teacher available to student’s schedule time. I have read, understood and agree to this Registration Form. Please initial here.


I accept terms and conditions above