Website: www.musik21.com Email: musik21@mindspring.com Tel: 404.245.6133 WELCOME TO MUSIK21 Conservatory How did you hear about Musik21 Conservatory? We offer and highly encourage our students to participate in recitals, competitions, festivals, and master classes organized by state, national and international organizations! We also offer recitals at least three times a year. Please inquire with your teacher about all details. We are very excited to be a part of your student’s musical experiences! FLAT RATE FEES: Tuition is due on the 1st day of each month. The first month’s tuition will be charged automatically to the credit card on file. Starting from the second month, we offer the following forms of payment: - Automatic credit card payment (subject to a 5% processing fee) - Zelle - Cash Please let us know which form of payment you select: Automatic credit cardZelleCash If payment is not received by the 5th of the month, we reserve the right to: - Add a $35 late fee to your outstanding tuition. - Charge the tuition and late fee to the credit card on file. 30 – DAY CANCELLATION POLICY Membership may be cancelled only by submitting our ONLINE CANCELLATION FORM. Our 30-DAY notice policy requests one month tuition to be paid from the day we receive the cancellation form. MAKE UP LESSONS Students are allowed to make up one lesson in the Fall semester (August- December) and one in the Spring semester (January-June) for excused absences (sickness, emergency situations), 24 hours’ notice accepted ONLY. Notice: No credits will be given for missed lessons. Lessons missed due to the teacher’s absence will be rescheduled. All make up lessons will have to be completed by the end of each semester. Would you allow us to publish your child’s pictures or recital videos: on Musik21 Conservatory website, YouTube, Facebook or any other promotional materials? YesNo Student will not be supervised outside the classroom, parents or guardians are responsible for picking student promptly at the end of the lesson. Studio will not be held responsible for student’s welfare. I agree to waive liability and release any and all claims against Musik21 Conservatory, its owners and teachers for injuries and damages suffered myself or my children 18 or under, for whom I am signing, during programs at Musik21 Conservatory, or while at Musik21 Conservatory for any other reason, whether in a class or not. I fully accept and assume all risks and all responsibility for all losses and damages as a result of my participation and any children’s participation in these programs. First name Last name Birth date Current age Grade in 2026-2027 school year Any medical issues/allergies we should know about? Parent or guardian information: First name Last name Address Street City/State/Zip Phone Cell Phone E-mail address Lessons requested at Musik21 Conservatory: Instrument: Teacher: Fee: 2nd Instrument: 2nd Teacher: 2nd Fee: Date of the first lesson Amount first month: Registration fee $60 TOTAL payment: Date of the first payment: Payment made by: Card holder name: Credit card number CVV ZIP / POSTAL CODE Expiration date Billing Address The student must be registered before the first lesson, otherwise the lessons will not be scheduled. To complete the registration the 1st payment must be done at least 48 hours before the first lesson – credit card payments only. Parent signature Date