Registration Thank you for enrolling online. Please complete and submit this form. One of our office staff will contact you on the next business day. At that time we will select a specific day and time for lessons to begin. Parent Name* First Last Student Name* First Last Email* Primary Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birthday* MM slash DD slash YYYY Grade* School* How Did You Hear About Us?GoogleFriendFacebook/Social MediaPrint AdMailersStorefrontOtherOther Instruments of Interest* Piano Guitar and Bass Voice Drums Violin/Viola Cello Upright Bass Homeschool Music Program Preferred Day of the Week* Monday Tuesday Wednesday Thursday Friday Saturday Sunday Preferred Lesson Length* 30 Min 45 Min 60 Min In Person or Virtual?* In Person Virtual Available Times* 1:30 - 3:30 3:30 - 5:30 5:30 - 8:00 8am-1pm (Sat. Only) Available Times* 1:30 - 3:30 3:30 - 6:00 Available Times* 8am - 10am 11am - 1pm Medical Conditions or Other Pertinent Information?Consent I agree to the commitment and payment schedule..(1) I accept the Class Schedule and Financial Responsibilities. Monthly tuition is paid by Auto-payment with a debit/credit card on file and is processed on the first day of the month. (2) I understand I am making a commitment to keep an updated auto-payment method on file and will notify RSM should my payment method change. I understand that monthly tuition is based on 47 lessons in the school year and my tuition will be the same each month. The cost of music is not included in tuition and will be charged to the student’s account. (3) I agree to give a written 30-day notice to withdraw from lessons. I understand I will be on the schedule for 30 days after submitting my withdrawal form. (4) I understand no refunds will be given if I choose not to attend all lessons before the 30 days are up and the required tuition shall be deemed fully earned. (5) I understand that any lessons I cancel or choose not to attend for any reason will be forfeited or made up by attending a Group Makeup Class. (6) I understand that any changes in scheduled lesson time that I request must go through RSM office personnel. Teachers do not make schedule changes. (7) I agree that I will not ask my instructor to teach me at any location other than at RSM while I am enrolled, and for one year after withdrawal. (8) I agree to communicate with my instructor only through RSM office email and will not request/share personal contact information including phone, email, or through social media. (9) I agree to accept a lesson from a qualified substitute teacher should my teacher be absent. (10) I agree to remain at RSM with my child under the age of 6. I understand RSM is not responsible for providing care before or after my child’s lesson and is not responsible for injuries sustained from normal lesson activity. I understand that RSM is not responsible for any damage or theft to vehicles in the RSM parking lot. Registration is $40 and paid today to hold your spot and begin the process. Registration fees are non-refundable unless no lesson times can work with your schedule. Monthly costs will vary based on the time and frequency of your lessons. Costs range from $139-$159.Registration Fee* Price: Total SignaturePhoneThis field is for validation purposes and should be left unchanged.