(914) 833-8941

Larchmont Music Academy

       2089 Boston Post Rd.

Larchmont, NY  10538 

 
 

 

Private Instruction Registration Form
 
Name of Student: _____________________________________________
 
Street Address: ______________________________________________
 
City: ___________________________  State: ______  ZIP: __________
 
Phone: __________________________  Date of Birth: _______________
 
Parent's Name: _______________________________________________
 
Emergency Phone: _____________________
 
Important Medical Information: __________________________________
 
Instrument: ________________  Teacher: ________________________  Lesson Day and Time___________________________________________
 
Starting Date: ___________

 

Cancellation and Refund Policy
Tuition 1: __________________
 
Tuition 2: __________________
 
Registration fee: $45.00
 
Total: _____________________
 
Payment: ___________________
 
 
I have read and understood the
cancellation and refund policy:
 
Signature: ______________________________
 

Office use:   QB     SV      RED
 
Cancellations and make-up lessons: Two private lessons  per semester will be made up. All cancellations must be made 24 hours in advance. If a cancellation is made without 24 hours notice no make-up will be given. All cancellations due to illness must be made before 10:00 a.m. in order to receive a make-up. Two opportunities will be offered for each make-up. If both are refused the lesson will be considered made up. If a student cancels their scheduled make-up lesson, it may not be rescheduled; the lesson will be considered made up. A qualified substitute can be sent in case of teacher absence. No make-up lessons will be carried over into the next semester. It is the responsibility of the student to schedule any make-up lessons.

 

Refunds: Registration fees are non-refundable. A Larchmont Music Academy credit will be applied to any withdrawal from individual instruction or classes until the fourth week of the semester on a prorated basis. However, no credit will be issued after the fourth week of classes, except in cases of prolonged illness. Tuition is fully refunded if the student withdraws before the first class or lesson. There are no refunds after the first class or lesson. LMA is not responsible for lost or stolen property