Registration Form Blank Form FINAL UPDATE (#8)Parent InformationStudent InformationClass InformationPayment InformationWelcome to New OpporTUNEities Studio! Please fill out this form once per student enrolling. Your musical journey is about to begin...Parent InformationPlease enter your information in the fields indicated below.Parent First Name: Parent Last Name: Parent Email Address: Parent Phone Number: Parent Cell Number: PreviousNextStudent Information, please enter your child's information in the fields indicated below.Student First Name: Student Last Name: Student Age: Student Birth Date: How many 30 minute lessons will this student be taking per week? - Select # of Lessons -1Lesson #1 - Student Instrument: - Select -PianoVocalAcoustic GuitarElectric GuitarBass GuitarViolinDrumsUkuleleSong WritingWorship Team TrainingRecordingLesson #1 - Student Instructor: - Select -Chris PrinsEleanor JesterBecki PrinsBeth Van DykenMichelle EbyDoes the student have any allergies? Yes NoPlease specify allergies: Do you give permission for pictures of the student to be taken and used for marketing purposes? (names never publicized) Yes NoOnline Lessons: All students are encouraged to provide an online method for lessons. This will assist your instructor in the event of last minute weather cancellations and other unforeseen circumstances to allow lessons to be taught at their usual time. Please select all of the options available to you from the following list:Online Method Selection: ZoomFaceTimeGoogle MeetFacebook Messenger Video ChatSkypeEmail Address (Zoom): Cell Number (FaceTime): Gmail Email Address (Google Meet): Facebook Username: Skype Username: PreviousNextClass Information, please fill out details on the lesson(s) below., ]:">Location of Lesson #1 [, ]: - Select -In Studio/OnlineIn HomeIn SchoolOtherLesson #1 - Day of the Week (In Studio/Online): - Select -MondayTuesday, Wednesday, ThursdayFridayLesson #1 - Day of the Week (In Home): - Select -Tuesday, Wednesday, ThursdayLesson #1 - Day of the Week (In School): - Select -OCS (Tuesday, Thursday)By Design Learning Centre (Wednesday)Lesson #1 - Password Lesson #1 Monthly Payment Fees: In Studio/Online (Monday) $90.00 for each monthLesson #1 Monthly Payment Fees: In Studio/Online (Tuesday, Wednesday, Thursday) $105.00 for each monthLesson #1 Monthly Payment Fees: In Studio/Online (Friday) $102.00 for each monthLesson #1 Monthly Payment Fees: In Home (Tuesday, Wednesday, Thursday) $122.50 for each monthLesson #1 Monthly Payment Fees: In School OCS (Tuesday, Thursday) $93.00 for each monthLesson #1 Monthly Payment Fees: In School By Design (Wednesday) $86.80 for each monthLesson #1 Monthly Payment Fees: Other $0.00 for each monthNo payment items has been selected yetPreviousNextPayment Information, please fill out payment information on the lesson(s) below.No payment items has been selected yetPay with Credit CardAuthorizationSignature Sign Here Authorization I have received a copy of the 2022/23 Student Handbook and agree to abide by its attendance and other policies. (If you have not received your copy, please email us directly at newopporTUNEities@gmail.com) Previous Submit Form
