Registration Form – All Lessons Summer 2015 – June 1 thru July 24 1750 20th Street, Vero Beach, FL 32960 Phone: (772) 562-7265 Fax: (772) 567-4440 Email: [email protected] Web: www.academyinvero.org Office hours: Mon. thru Thurs. 9:00 am – 12:00 pm Music Lesson Scheduling (Check one) 30 Minute Lesson 45 Minute Lesson 60 Minute Lesson Group Lesson 21st Year! Lesson Day and Time Availability 1st Choice 2nd Choice 3rd Choice Availability: Location: New students, how did you learn about the Academy? Student Information: Name (Last, First) Instrument & Instructor If under age 18, Date of Birth & Age Home Phone Street City, State, Zip Mailing Address: School/Employer Student Cell Phone Email: @ Mother/Guardian: E-Mail Address for Academy business (only) Name (Last, First) Work / Cell Phone - MOM Name (Last, First) Work / Cell Phone - DAD Father/Guardian: I understand that I am responsible for payment of the full tuition even if the student discontinues lessons. I have read, understand, and accept all conditions of registration as described on this registration form (pages 1 & 2) and agree that electronic transmission of typed signature is intended and accepted as original. I will advise of contact changes. Signature: Parent (or student over 18 years of age) _____________________________________ Date _________________ Non-Refundable tuition may be paid in full or by agreement to a payment plan (see pg 2). Payment at Registration $ _______ Credit Card Payment: Visa Card No: _____ _____ ____ ____ Check, Number: _______ Mastercard Discover Exp. Date: ____/_____ CW2 Code (back of card): ______ Zip Code: _________ Street Address: ___________________________________ Amount to Charge: $_________+fee (No corporate cards please) Name (print as it appears on card): _____________________________ Authorized Signature: _________________________________ I want to auto-pay for payments - 15th of June & July Date Received in APA office _____________ NOTES: Cash Credit (+small processing fee) ~ OFFICE USE ONLY ~ Tuition $ Payment Plan Fee Credits / Late Start,Week____ Scholarship Award _____% Balance after Credits Paid at Registration Balance Due $ SUMMER 2015 June 1 – July 24 (8 Weeks) TUITION Length of Lesson In Full 30 Minutes 45 Minutes 60 Minutes Groups $ $ $ $ On-Line or Credit Cards 220 316 420 146 $ $ $ $ 228 328 435 152 $20 registration fee is included for private lessons, $10 group lessons Group tuition based on a minimum of 5 students; tuition will be pro-rated if less. HOLIDAYS There are no holidays this semester PAYMENTS The Academy accepts cash, check, Visa, MasterCard, & Discover (and PayPal online) A small processing fee for credit/debit cards will be applied. (For payment plan, there is an auto-pay option - just check box on pg 1) PAYMENT PLAN (optional) Lesson Length 30 min. 45 min. 60 min. Groups Payment Due: At Registration $ 75.00 $ 135.00 $ 200.00 $ 50.00 Jun 15 75.00 95.00 116.00 50.00 July 15 75.00 95.00 116.00 50.00 Payment plan fee included - THERE IS A $25 LATE FEE FOR PAYMENTS RECEIVED 7 DAYS LATE. Credit Card or Online Payments require a 3rd party transaction fee for each payment – please add 3.5% ACADEMY POLICIES Full tuition must be paid even if a student discontinues lessons. The non-refundable tuition is to be paid in full at registration or by following the payment plan option. The only exception with the Summer Semester is that UPON REGISTRATION you let us know if there are planned vacation days and you cannot come certain weeks, we will either credit your account or provide a makeup lesson. Registration & payments can be made online, mailed, faxed or brought in person to our office during office hours (9:00 am–12:00 pm Mon thru Thurs), there is also a convenient drop box at STUDIO 1305 and is available during lesson times. Registration is complete upon receipt of the registration form and payment. Payment reminders are sent via email. Scheduling is on a first come-first serve basis each semester. Please list the student’s preference of day/time or availability on the top of the form. Payment & Scheduling ~ If a student is not able to attend a scheduled lesson, please contact the office during office hours or instructor if you have been given their phone number. Makeups or credits cannot be offered for student absences. At the beginning of the semester, specific days and times for lessons are agreed upon between parents/guardians, students & instructors through the Academy Office. If an instructor is absent, every effort will be made provide make up lessons. Once a makeup appointment has been confirmed by both student and instructor, cancellation by student is considered a student absence. If instructor absence makeups cannot be scheduled, a credit towards future tuition costs may be issued. The same policy will apply to cancellation due to inclement weather. Absence Policy ~ The Academy will not share or sell your personal, credit card or bank account information through email or any other means unless directed by law enforcement via summons or court order. Privacy Policy ~ From time to time still and video photography is made during APA activities and used in the seeking of grant funding, and promotional and historical documentation. I/We hereby grant permission the above mentioned minor may be included in photography of APA activities. I/We hereby irrevocably grant to APA, the right to use these photographic images as a result of the student’s participation in activities of APA. Photography Consent ~ Other ~    Children arriving for private and group lessons are to be escorted to studio and all children must be met at the classroom door at the end of each lesson. For lessons provided at off-campus locations, there is a $20 late fee if child is picked up more than 15 minutes after lesson ends. The Academy is not responsible for musical instruments or any personal belongings left on the premises. The Academy will place a message on the telephone answering system regarding cancellations/resuming classes in the event of inclement weather. The Academy for the Performing Arts admits students of any race, color, religion, handicap, national and ethnic origin to all rig hts, privileges, programs and activities generally accorded or made available to students at this school. It does not discriminate on the basis of race, color, religion, handicap, national or ethnic origin in administration of it’s educational policies, admission policies, scholarships and other school-administrated programs.