Enrollment Form | Lanis' Piano Studio

Lanis Piano Studio Enrollment Form
Thank you for your interest in our private piano lessons! Please complete this enrollment form only after receiving confirmation.

Student First Name

Student Last Name

Student's Birthday required

Parent(s) Name(s)

Phone

Address

Emergency Contact Name/Phone Number

Allergy Information

Does the student have any special needs?

Student's Reserved Lesson Day and Time Slot

Do you have any questions or comments?

Student Media Release Waiver: I grant permission for Lanis Piano Studio to photograph, record, and/or video my child during lessons, recitals, and studio events. These materials may be used for educational, promotional, or marketing purposes, including the studio's website, social media, and printed materials. No financial compensation will be provided. I may request removal in writing at any time. Required

YES, I give permission.

NO, I do not give permission.

Hold Harmless Agreement: I acknowledge that piano lessons involve minimal physical activity but understand there is some risk of injury or property damage. I agree to hold harmless Lanis Piano Studio, its owner, instructors, and affiliates from any liability, claims, or damages arising from participation in lessons, recitals, or studio activities. Required

By signing below, I confirm that I have read and understand this agreement.

Your Signature