Private Lessons Registration-PV Symphony

Private Lessons Registration

We ask everyone interested in private lessons who hasn't been a student with us yet to register. This helps us find you the best teacher and lesson plan! Please fill out a registration for each student. Send any questions to music@pvso.org.

STUDENT INFORMATION

Student First Name

Student Last Name

Student Pronouns

Instrument

Level of experience with instrument

If you have a preferred teacher (or teachers), name them here.

What lesson times work best for you?

Weekday mornings

Weekday afternoons

Weekend mornings

Weekend afternoons

CONTACT INFORMATION

Primary Billing Contact First Name

Primary Billing Contact Last Name

Address

Phone Number

Emergency Contact First and Last Name

Emergency Contact Phone Number

POLICIES

Read each policy below and select the "I agree" box beneath each one. Additional policies and information are available at pvsoc.org/classes by following the "Costs & Policies" link.

ABSENCES: The student must notify the teacher of an absence from a lesson with 24 hours' notice to be considered excused. One excused lesson will be made up by the teacher per semester. Lessons and classes missed due to teacher absence or snow days will also be made up by the teacher. Students are financially responsible for unexcused absences and excused absences beyond the first one. Teachers will do their best to make alternate arrangements if they know about an absence ahead of time (the earlier the better!) but this will not always be possible.

I agree to the Absence Policy

SNOW POLICY: In-person lessons and classes may be canceled due to snow and ice. Call the office at: 413-773-3664 to find out if there is a cancellation. As a general rule, if Greenfield Public Schools are closed due to weather, lessons will be canceled.

I agree to the Snow Policy

PHOTO AND MEDIA RELEASE: Students' likeness, or a representation of their likeness, are sometimes used in public materials developed by or on behalf of the PVS, including posters, photographs, videos, films, and multimedia productions. By agreeing to this policy, you release the PVS and its licensees from all liability for any claim of infringement of publicity or privacy rights in connection with the likeness of the student (yourself or the minor student on whose behalf you complete this form).

We believe that using photos of our student musicians in our print and web publications fosters a greater sense of community, and supports the growth and vitality of music education. However, you have a right to opt out of this photo and media release below or at any time by contacting us in writing via mail to our office or e-mail to music@pvso.org.

I agree to the Photo and Media Release

Yes

IF THE STUDENT IS UNDER THE AGE OF 18, A GUARDIAN MUST COMPLETE THE SECTION BELOW.

MEDICAL TREATMENT PERMISSION: I authorize the PVS, through its representatives in whose care the Participant has been entrusted, to consent to any emergency medical, surgical, or dental examination, diagnosis or treatment and hospital care, to be rendered to the Participant under the supervision and on the advice of the medical staff of a licensed hospital or emergency care facility. I shall be liable and agree to pay all costs incurred in connection with such services.

I agree to the Medical Treatment Permission.

Student's Age (if under 18)

Full Name of Authorizing Parent/Guardian

Relationship to the Student

THANKS FOR YOUR INTEREST

How did you hear about us?

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