Group Lesson Agreement Form

This form is for preschool and kindergarten group classes only.

Thank you for your interest in taking lessons at Lynchburg Music Center. Please fill out our Student Agreement Form to begin!

Once you have completed the form, please give us at call or stop by our store to schedule your first lesson and pay your tuition.

Address

6006 Fort Ave

Lynchburg, VA 24502

Phone

(434) 237-0073

Student First Name

Student Last Name

Age

Name of Parent/Legal Guardian

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

Alternate Phone

Instrument/Class

I understand that completing this Agreement Form does not guarantee the availability for lessons with my desired instrument/class.

I understand that I must call or stop by Lynchburg Music Center to schedule lessons. Lesson appointments will not be reserved until payment is made for the first month.

Parent/Guardian Supervision:

All students under the age of 12 MUST be accompanied by a parent/guardian during the duration of the lesson.

Parent/guardian is not required to be in the studio and may sit in the hallway.

Parent/guardian needs to be easily accessible to the instructor in the event of behavioral issues or potential emergencies.

Parent/guardian understands that, while students will never be left unattended, LMC and its instructor(s) are not to be held responsible for any altercations that may arise between students.

Parent/guardian acknowledges that, while students will never be left unattended, LMC and its instructor(s) shall not be held liable for any injuries students may incur due to accident or altercation with another student.