Re-enrollment Form - 2020

Re-enroll today for 2020 lessons at Panharmonic Music Studio.

Before you complete the re-enrollment form below, please read our Studio Policy and Participant Agreement, Waiver & Release as you will be required to acknowledge the contents of them below.

Anything Changed?
If your information is still the same as when you enrolled, click the "Still the Same" button. If something has changed, click the "Need to Update" button and enter the new information below.
Student 1 Name *
Student 1 Name
Student 2 Name
Student 2 Name
Student 3 Name
Student 3 Name
Student 1 Date of Birth
Student 1 Date of Birth
Student 2 Date of Birth
Student 2 Date of Birth
Student 3 Date of Birth
Student 3 Date of Birth
Phone Number
Phone Number
Address
Address
Legal Release *
I, the undersigned, do hereby grant permission to Panharmonic Music Studio (aka, “The Studio") to post my and/or my child’s story, photo, or other items, hereinafter referred to as “Materials,” to be used in social media (e.g., Facebook and/or Instagram) and/or other promotional material for The Studio.

I acknowledge and agree that no sums whatsoever will be due to me as a result of the use and/or exploitation of the “Materials” or any rights therein.

I acknowledge that my child is under 18 years old and lacks the legal capacity to enter into binding agreements. Accordingly, I have read this Release and consent to my child’s inclusion in the Materials will not contest the rights granted in this Release, and shall assist and support you in any and all legal proceeding for affirmation of this Agreement, should you choose to have a court of law affirm this Agreement.
Acknowledgment of Studio Policy *
Acknowledgment of Participant Agreement, Waiver & Release *
Student or Parent/Guardian Electronic Signature *
Student or Parent/Guardian Electronic Signature
Parent/Guardian's Birthday *
Parent/Guardian's Birthday
This confirms that you are over 18 and the actual parent/guardian.