Registration Form Private Lessons - Grosso Music & Fine Arts

Parent Name *

First

Last

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Preferred Contact Method

Text
Call
Email

Lesson Location Preference *

South Tampa
Lutz

Instrument *

Child Name *

First

Last

Grade

Child Name 2

First

Last

Child 2 Grade

Additional Children being registered (Name and Grade). Please list Allergies and any additional information.

Please provide available days and times for lessons. *

Emergency Contact *

First

Last

Phone

Private Lesson Policies & Procedures *

I have read and understood the Private Lesson Policies & Procedures

Grosso Music and Fine Arts Corporation Photo Release

I hereby grant permission for video recordings and digital photographs to be taken of my child or my child’s work as part of her/his participation with Grosso Music and Fine Arts Corporation (Hereinafter referred to as GMFA}. I authorize GMFA to use my child’s image on its websites and/or in printed promotional materials without further consideration and I acknowledge GMFA right to treat the media (such as cropping) at its discretion. I also acknowledge that GMFA may choose not to use my child’s image at this time, but may do so at its own discretion at a later date. I understand that once my child’s image is posted on the GMFA website, the image could possibly be downloaded by a third party. I agree that I will not hold GMFA responsible for any harm that may arise from such unauthorized reproduction.

GMFA Group Lesson Information and Policies *

I have read and agreed with the GMFA Lesson Information and Policies

I have read the GMFA Photo Release *