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Please note: Registration booking form and the fees must paid prior to beginning music sessions at ROA.

Choose an instrument *

Name*

Address*

Date of birth*

Email*

Home Phone

Cell Phone*

How did you find out about us?*

Tell us what level of experience you have in your chosen music-making option

Please summarise your experience

**The following MUST be completed if student is under 18

Emergency contact name*

Emergency phone*

This section is optional for students over 18, but recommended

Details of any medical conditions we should be aware of

What you need to bring to your sessions: (please note that we supply all instruments while attending lessons, however, the students are required to bring their own headphones,pics, and drumsticks. Water is recommended for vocalists.

Terms of agreement: (by signing this form you agree to be bound by all of the following):

Payments: On joining Rock Of Ages, you agree that payments are to be made prior to any instruction. Ongoing payments are due the first of every month without exception.

Make-up classes: We regret we are unable to make–up same day missed lessons, however, if given 1 weeks’ advance notice, we will happily reschedule the student for a make-up class the same week.

Tutors: In the event of tutor illness/holidays you may sometimes be taught in larger groups than normal. We reserve the right to rotate and substitute tutors at our discretion.

Staff training: On occasions we may record lessons for staff training using audio/video methods.

Disclaimer for promotional Purposes: I understand that the picture and/or video taken at Rock of Ages Music School may be used for promotional purposes.

Are you 18+?

Student Name*

Date*

Signature of Student*


MUSIC ROCKS!