Spring 2010

Please fill out the following form to register for Spring 2010.

A seperate form is required for each student.

Spring Registration Fee $25 per family

Choose 1 or more of the following instruction offered:

Piano	Trumpet	Flute
Guitar	French Horn	Clarinet
Drums	Trombone/Baritone	Saxophone
Voice	Tuba	Violin
Oboe

Choose 1 or more of the following form of instruction:

Private Lessons $125.00 per month 30 minute lesson time. No discounts apply. Children’s Choir $50.00 per month, 45 minute class time. No discounts apply. Classes $75.00 per month (Discounts available for multiple classes, family members)

Discounts-10% off additional class, 20% off additional family members

Payment Options: Choose One

Option 1 Pay semester fees in full at time of registration **Cash, check or credit card**

Option 2 Pay the semester fees in monthly payments **CASH OR CHECK ONLY**

Cash, Check or Credit Cards Accepted. Monthly payments are due by the first day of each month. Monthly invoices will not be mailed out.

Electronic Signature of Responsible Party:

Date:*

Student Name:

Select one:

New to Manzi's Music Returning Student

Age if under 18:

Grade in school: School Attending:

Does student have any special needs we should be aware of?:

No Yes

If yes, please explain:

Parent/Guardian:

Address:

City:

State:

Zip Code:

I have read and I agree to Manzi's Music Policy and Agreement Form. You may download a copy on the forms page of our website.

NO YES

Phone Number:

Cell Phone:

Email Address:

Check if CHANGE OF ADDRESS since last registration

Please contact us if you have questions or would like more information|www.manzismusic.com|(863)709-1401

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