Early Childhood, Instrumental Classes & Private Lessons
Alice S. Pfaelzer Tuition-Free Conservatory
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Merit School of Music
Returning Student Private Lesson Application
Returning Private Lesson Student Application Form
This form is for students who currently study with a private lesson teacher at Merit School of Music
Current Teacher's Name
Length of Lesson
(Indicate NA if Adult Student)
Please enter your preferred phone number below for scheduling/billing purposes.
Please enter your preferred e-mail below for scheduling/billing purposes.
Method of Payment
If you have a credit/debit card on file at Merit please list the LAST 4 DIGITS if you would like us to apply charges to the same card.
Student Waiver and Enrollment Policy Agreement
In consideration of my (and/or my child’s) participation at Merit School of Music, I hereby release and discharge Merit School of Music, and its representatives, successors, and assigns, from any and all liability arising from accident, injury, and illness that I (he/she) may suffer as a result of my (our) participation. I (we) also will follow the rules and regulations set by Merit School of Music and above named parties. Parent or guardian must sign for anyone age 18 and under. PRIVATE LESSON ATTENDANCE POLICY: There are no excused absences for private lessons. Students are expected to be present and on time to all lessons and classes. Families are responsible for payment of all lessons whether or not the student is in attendance. Private lesson teachers are not required to reschedule lessons due to student absences or tardiness, however, make-up lessons can be given with instructor discretion. If the student is unable to attend a scheduled lesson, please contact the individual private lesson teacher directly at least 24 hours before a planned absence. If the instructor cancels the lesson or is late, the teacher is responsible for making up that lesson time. Merit may dismiss any student from private lessons with three consecutive absences without notification; who has a pattern of absences; who is consistently tardy; or who fails to adhere to their payment schedule. I do hereby grant and give these groups the right to use my or my child(s) photograph or image with or without my or my child's name, both singly and in conjunction with other persons or objects and presentations, advertising, publicity, and promotion relating thereto and in accordance with all the terms and conditions of Merit's policies.
By checking this box, I acknowledge that I am at least 18 years of age and have read, understand and agree to fully support all policies and procedures
Yes, I agree to the policies and procedures.
This field is for validation purposes and should be left unchanged.