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Student Information
Name
*
First
Last
Age
*
Instrument
*
Lesson Format:
In-Person lessons on site at Taylor's
Virtual lessons
*Please note: any changes to your lesson format must be sent to lessons@taylorsmusic.com*
Instructor Preference
Preferred Day/Time
Please describe the student's level of experience and stylistic preferences, as well as any learning accommodations they may need. This will help us match you with an instructor.
How did you hear about Taylor's Music Lessons Program?
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Facebook
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School music teacher
I'm a Taylor's customer
Current Taylor's student referred me
Other
If applicable, who referred you to Taylor's Music Lessons Program?
Customer/Payer Information
Name
*
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Last
Relationship to Student:
*
Parent/Guardian
Self
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Primary Phone Number
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Secondary Phone Number
Email
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Billing Address
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Credit Card
*
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
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Year
Year
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Registration Fee
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Price:
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Total
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Video/Photo Release
*
Yes, I give permission.
No, I do not give permission.
I give Taylor's Music Store & Studios permission to take photos and/or videos during lessons/classes, whether through virtual teaching platforms or in person, of the student named above for use on the Taylor's website, social media pages, advertisements and/or other promotional materials.
Private Lessons Agreement
*
I understand that in-person private lessons are held on-site at Taylor’s and that wearing a mask is optional. I may need to purchase books as well as bring my own instrument to lessons except for piano and drum kit lessons. I have read the Taylor's Lessons Agreement below and give Taylor's Music permission to enroll my credit card in monthly autopay once lessons have been scheduled with an instructor. By submitting this form, I consent to the attendance, billing, and scheduling policies outlined therein.