New Student Registration

New

New Student Questionnaire - Level 5-8 intermediate

Student Name *

First

Last

Age *

Instrument *

Additional Student Name

First

Last

Age

Instrument

Imagine if you had taken lessons here for one year and you were talking to a friend about your experience, and you wanted to tell them what you or your child gained from this experience...

What is the most important skill or song that you or your child would like to learn how to perform? *

What is your (or your child’s) favorite kind of music? *

Do you want or do you want your child to perform in our recitals? (they are LOW PRESSURE and 100% OPTIONAL!) *

Do you or your child want to learn how to read music? *

Do you or your child want to learn theory? *

Do you or your child want to learn how to improvise (jam)? *

What are your 6 month goals? *

What are your 12 month goals? *

We realize that everyone is here for intensely personal reasons. Please let us know why you or you child is here and what we can do to make sure that you learn what you want to learn. What do you or your child want to learn? *

Comments *

New Student Enrollment Form

How did you hear about Miami Berpro Music Academy? *

Today's Date *

Student Name *

First

Last

Student Birthdate *

Male/Female *

Male
Female

Additional Student Name

First

Last

Student Birthdate

Male/Female

Male
Female

Parent/ Guardian Name *

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Cell Phone

Work Phone

Email *

Emergency Contact Information

Emergency Contact #1 *

First

Last

Relationship *

Home Phone *

Cell Phone

Work Phone

Image & Audio/Video Recording Waiver

At the Academy we host an annual picture day that is very popular with our parents. A photographer visits the school and takes pictures of the students and parents get to order copies. We also videotape and photograph recitals occasionally. In our monthly newsletter we feature students of the month, videotape student performances for YouTube and our web site. If you would like for you or your child to participate in student of the month, picture day, recitals or our newsletter, please answer "Yes" on this image and video/audio recording waiver. Answer Below: *

Yes, I give permission for the image, audio and or video recording of my child, to be used by the Miami Berpro Music Academy LLC
No, I do not give permission for the image, audio and or video recording of my child, to be used by the Miami Berpro Music Academy LLC

Sign here after completing Image & Audio/Video Recording Waiver:

Policies & Procedures

TUITION 1. All payments are processed by pre-authorized credit cards or auto draft from checking accounts on the first of the month. Private lessons are $120 per month for weekly 30 minute sessions at our location, $240 per month for weekly 60 minute sessions. There is a $25 registration fee due ONLY at time of registration. Tuition is never prorated for missed lessons. Tuition does not include any retail teaching materials such as books or instruments. *

Click to indicate that you understand and accept

CANCELLATIONS AND MAKEUPS 2. For any lessons missed by a teacher, the Academy will attempt to provide a substitute teacher. If a substitute teacher is unavailable, a private makeup lesson with the teacher will be scheduled promptly. In the event of school closing due to severe weather, we will reschedule private lessons during a holiday break. For any lesson missed by a student, the Academy holds one hour group make up classes every weekend. The classes are age and level appropriate and are held between the hours of 10 am and 6 pm. To sign up for a makeup class, contact the office and not the instructor for a date and time. If the student does not have an instrument at home to use during the lesson, the lesson must be rescheduled for a group makeup class at the Academy. *

Click to indicate that you understand and accept.

DISCONTINUING LESSONS 3. Every student here is on a month-to-month basis. To discontinue lessons and to discontinue charges to your account, fill out the withdrawal form before the 15th of your last month. We do not prorate tuition for the last month’s lessons. Students will be responsible for their last month’s tuition whether or not they attend lessons. *

Click to indicate that you understand and accept

AVERAGE OF FOUR LESSONS PER MONTH 4. Monthly tuition is based on a 48 week year. We are closed for four weeks for holidays. In the long months, you will get five lessons, short months such as November and December, you will get three lessons, and most months you will get four lessons. The tuition is the SAME each month; i.e. we don’t charge you more when you have five lessons, and we don’t charge you less when you have three lessons in a month. This makes everyone’s accounting easier.

Click to indicate that you understand and accept

SUMMER VACATION 5. The Miami Berpro Music Academy operates year-round and does not close for the summer. We are happy to offer unlimited makeups for our students, and they are held every Saturday. If you are taking a month off for vacation and want to resume the next month, your payment is still due on the first of the month to reserve your lesson space. The lessons for the month you miss can be made up when you return from vacation. *

Click to indicate that you understand and accept.

CARE OF STUDENTS 6. The school is not responsible for providing before or after care for students. Parents with children under the age of eight must remain in the school lobby during the classes. Students are not to be left at the school for excessive time periods before or after their lessons. *

Click to indicate that you understand and accept.

OPEN DOOR POLICY 7. Parents are always allowed to sit in on lessons. We have an open-door policy for lessons. *

Click to indicate that you understand and accept.

INJURIES 8. Parents, legal guardians of minors, students and adult students waive the right to any legal action for any injury sustained on school property resulting from normal lesson activity or any other activity conducted by the students or their siblings before, during, or after lesson time, including hearing loss or hearing damage. The Miami Berpro Music Academy is not responsible for any damage done to vehicles or items stolen from vehicles. *

Click to indicate that you understand and accept.

PICKING UP 9. Children must wait for their parents to pick them up inside the Academy. Please do not ask them to meet you elsewhere. Students are not to be dropped off on the street or curb. The Academy assumes no responsibility for children who leave unaccompanied. *

Click to indicate that you understand and accept.

Sign here that you have read, understand, and agree to abide by these policies: *

Authorization Agreement for Payment

Payments are recurring and are deducted on the first of each month until a withdrawal form is submitted to the Academy office. Withdrawals are due by the 15th of your final month to prevent charges on the following month.

Payment Method *

Auto Draft From Checking Account (Submit Voided Check)
Auto Draft From Credit/Debit Card

(I/We) do hereby authorize the MIAMI BERPRO MUSIC ACADEMY, LLC, hereinafter named the COMPANY, to initiate recurring (debit or credit) entries to (my/our) (Credit Card Account) as indicated and named below as the depository financial institutions, hereafter named FINANCIAL INSTITUTION. (I/We) acknowledge that the origination of ACH transactions to (my/our) account must comply with the provisions of U.S. law. Furthermore, if any such debit(s) should be returned NSF, (I/we) authorize the COMPANY to collect such debit(s) by electronic debit and subsequently collect a returned debit NSF fee of $25.00 per item by electronic debit from my account identified below, and authorize all of the above as evidenced by my signature below.

This authorization is to remain in full force and effect until the COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the COMPANY and FINANCIAL INSTITUTION a reasonable opportunity to act on it.

I have read and understand the Miami Berpro Music Academy policies and procedures and payment authorization agreement and agree to abide by them.

Sign here after reading policies, payment authorization and waivers.

Type Your Name *

New Student Registration

New Student Questionnaire - Level 5-8 intermediate

Imagine if you had taken lessons here for one year and you were talking to a friend about your experience, and you wanted to tell them what you or your child gained from this experience...

New Student Enrollment Form

Emergency Contact Information

Image & Audio/Video Recording Waiver

Sign here after completing Image & Audio/Video Recording Waiver:

Policies & Procedures

Sign here that you have read, understand, and agree to abide by these policies: *

Authorization Agreement for Payment

Payments are recurring and are deducted on the first of each month until a withdrawal form is submitted to the Academy office. Withdrawals are due by the 15th of your final month to prevent charges on the following month.

This authorization is to remain in full force and effect until the COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the COMPANY and FINANCIAL INSTITUTION a reasonable opportunity to act on it.

I have read and understand the Miami Berpro Music Academy policies and procedures and payment authorization agreement and agree to abide by them.

Sign here after reading policies, payment authorization and waivers.

IT'S EASY TO TAKE THE FIRST STEP

Ready to start? You have nothing to lose.

Sign up is easy and parent-friendly, with helpful staff at the front desk six days a week to serve you. Because we only offer lessons on a month-to-month basis, there are no large upfront payments, no complicated contracts, no annual material and no semester minimums.

Lessons are first come, first serve, so contact us today to arrange your first lesson!