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SCHOOL YEAR ENROLLMENT

Music With Mindy Learning Studio

Private Lessons

Contact Information ✦ Business Agreement ✦ Photo Release

2021 - 2022

Contact Information

Student Name:________________________Date:___________

Parent(s)Name:_____________________________________

Address(include zip code)_____________________________

__________________________________________________

Email:_____________________________________________

Home Phone:_____________Cell:_____________text ok____ 

School:_____________________Grade:__________Age:____

Photo/Video Release

I,_____________________________, give permission to photograph and/or video my child __________________at MusicWithMindy Learning Studio during music lessons, camps or group activities. I also give permission for any images taken to be used on the studio bulletin boards, website, social media and printed promotional materials for the studio.

   Business Agreement for Private Lessons

Parent Please Read Carefully and Initial:

_____I have read the Private Lesson Guidelines located at musicwithmindy.com and agree to these terms.

_____ I will check the assignment book each week for any messages sent home and will encourage daily practice.

_____I have read the policies regarding absences, and realize that it is my responsibility to request a make-up lesson when I call to cancel.   

           Monthly Tuition is due on the 1st of each month.

               CHOOSE AN OPTION:

 _____1. I will pay for the number of lessons scheduled for that month OR  

 _____2.  I will pay at every lesson.                                                         

_____I will contact Mindy in the event of any financial hardship or special circumstance regarding payment. 

_____I understand that the lesson schedule is on the website. The next scheduled lesson is noted in my child’s assignment book. Requests for changes may be noted there by myself or Mindy or via phone or email as needed.

Parent Signature:_________________________________

Date:_____________________

            



   












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GROUPS CURRENTLY SUSPENDED

DUE TO COVID-19

And Teen Adaptive Classes

Information and Registration Form

2019-2020

NOW OFFERING A TEEN/YOUNG ADULT CLASS!!!

FRIDAY AFTERNOONS AFTER SCHOOL...ADULTS MAY ATTEND AS DESIRED. A VARIETY OF MUSIC STYLES, RECORDING ARTISTS, AND MUSIC-MAKING EXPERIENCES. COME JAM WITH US IN "THE BACK ROOM ." 10 WEEK SESSION - $300 PER SESSION

*USE ENROLLMENT FORM BELOW

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PRESCHOOL/SCHOOL-AGE Adaptive CLASSES 

COME AND EXPERIENCE THE JOY OF MUSIC TOGETHER® CLASSES WITH YOUR CHILD WITH SPECIAL NEEDS. CLASSES WILL BE LED BY MINDY ARNDT, A BOARD-CERTIFIED MUSIC THERAPIST WITH OVER 30 YEARS EXPERIENCE WITH CHILDREN AND ADULTS WITH SPECIAL NEEDS AND DISABILITIES.

MUSIC THERAPY PRINCIPLES AND MUSIC TOGETHER REPERTOIRE WILL BE COMBINED TO ADDRESS THE DEVELOPMENTAL NEEDS OF YOUR CHILD IN A SMALL GROUP SETTING . *****************************************************************************************************

THESE PARENT/CHILD CLASSES WILL MEET ONCE A WEEK FOR 10 WEEKS AND ARE 30 - 45 MINUTES LONG, DEPENDING ON THE NEEDS AND ABILITIES OF THE ENROLLED CHILDREN. SIBLINGS AND ADDITIONAL ADULT FAMILY MEMBERS ARE WELCOME. THERE WILL BE A MAXIMUM OF 4 FAMILIES PER CLASS.

Tuition: *****$300 - CHILD (see below

for discount info) 

classes are held at: MUSIC WITH MINDY LEARNING STUDIO,

153 Picwyck Dr, Mooresville, NC 28115

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Music With Mindy Learning Studio

MUSIC THERAPY GROUP ACTIVITY

please complete and mail with payment to address below*

REGISTRATION FORM

CHILD'S NAME____________________________________DATE_______________

CHILD'S AGE__________TYPE(S) OF DISABILITY___________________________

_____________________________________________________________________

SCHOOL_______________________________________IEP?______YES______NO

PARENT'S NAME___________________________PHONE#_____________Text?___

Caregiver, if Attending with Child_________________________________________________________________

ADDRESS_______________________________________ZIP CODE_____________

E-MAIL ADDRESS______________________________________________________

NEW REGISTRANT____YES____NO TOTAL AMOUNT DUE $________________

PRESCHOOL AGE CLASS: Time Set as needed

TEEN CLASS: FRIDAYS 3:30pm @ MOORESVILLE STUDIO

 ELEMENTARY AGE CLASS: Time Set as needed                                                    

PLEASE INDICATE YOUR CLASS PREFERENCE_____________________________

ENROLLMENT AFTER START DATE MAY BE ELIGIBLE FOR PRO-RATED DISCOUNT.

$20 DISCOUNT IF PAYMENT IS RECEIVED AT LEAST ONE WEEK PRIOR TO START DATE. CREDIT TOWARDS NEXT SEMESTER MAY BE GIVEN IF YOU WITHDRAW BEFORE THE FIRST CLASS, OR IN SPECIAL CIRCUMSTANCES. TRY A CLASS WITH NO OBLIGATION.

PARENT SIGNATURE___________________________________DATE____________ 

*CHECKS PAYABLE TO: MINDY ARNDT

*MAIL TO: MUSIC WITH MINDY LEARNING STUDIO, 153 Picwyck Dr, Mooresville, NC 28115

  Questions? 704-677-2007          [email protected]

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