PLEASE FILL OUT THE FOLLOWING INFORMATION IN ORDER TO COMPLETE REGISTRATION.
I. STUDENT INFORMATION
II. REGISTRATION INFORMATION
III. PAYMENT INFORMATION
IV. CREDIT/DEBIT CARD INFORMATION
While you may choose your preferred form of payment, we still keep a credit card information on file for security purposes.
V. SCHOOL POLICIES & GUIDELINES
Please read the STUDENT HANDBOOK, provided via email from email@example.com and available on the student portal under "Online Resources."
VI. LESSON LIABILITIES & RELEASES (also available to read on the student portal)
1. CHILD SAFETY. To ensure your child’s safety, please be sure to pick him/her up promptly after class/lesson
time. Steeple Street Music Academy’s instructors and staff do not supervise children waiting in hallways
before and/or after classes/lessons. Children are under supervision during their instruction time only.
Neither instructors nor staff are responsible for supervising children outside of teaching time.
2. MEDICAL EMERGENCIES. Unless written notice is given to the studio, permission is granted to Steeple
Street Music Academy and its operators to seek medical treatment for the participant in the event they
are not able to reach a parent or guardian. Parent/Guardian must also submit written notice for any
physical/mental problems, restrictions or conditions.
3. INJURIES. Parents, legal guardians of minor students and adult students waive the right to any legal
action for any injury sustained on school property resulting from normal lesson activity or any other
activity conducted by the students before, during or after lesson time.
4. RELEASE OF LIABILITY. Parents, legal guardians of minor students and adult students fully waive and
relinquish any and all claims against Steeple Street Music Academy and its owners, instructors, agents
and employees from injuries or damages as a result of participating in any activities or classes in any
way associated with Steeple Street Music Academy. Parents, legal guardians of minor students and
adult students further agree to indemnify and hold harmless Steeple Street Music Academy from any
and all claims resulting in injuries, damages arising out of, connected with or in any way associated
with the activities of any of the programs.
4. PHOTO/VIDEO RELEASE. Steeple Street Music Academy is hereby granted permission to take photographs and or
video of the students to use in newspaper, TV press release, brochures, websites, posters, and other
promotional materials the school creates. Please be aware that these photos or recordings are for
promotional purposes and may be used in future print or electronic publications and media
communications. Permission is also hereby granted for the school to copyright such photographs and
video footage in its name. By participating in Steeple Street Music Academy’s programs, you consent to
the video or audio recording or taking of photographs for these purposes. Prior approval from the
student/parent will be asked if personal information is to be attached to the photos or recordings.
6. CHANGES & UPDATES. We reserve the right to update or modify these policies at any time and without
prior notice unless a material change is made; in which case we will notify you through the email you
have on file. Your use of our services following any such change constitutes your agreement to follow
and be bound by the policies as changed.
THANK YOU FOR REGISTERING WITH STEEPLE STREET MUSIC ACADEMY! WE LOOK FORWARD TO HAVING YOU A PART OF THE COMMUNITY!