Student Registration Form

I confirm I have read and agree to the policies and pricing document for Stacy's Studio of Music.*

Authorization for Emergency Medical Attention:  In the event that I cannot be reached to make arrangements for emergency attention, I authorize Stacy Caldwell to arrange treatment at the closest medical facility.*

Release of Liability:  I, being the parent or guardian of the above stated child, release Stacy Caldwell from any potential liability for any and all claims of injury, illness including COVID, and/or accident which may directly or indirectly result from my child’s participation in piano lessons. *

Registration Fee:  A $50 registration fee is due at the time of submission. By checking this box, you confirm you understand and will submit payment via Zelle, Venmo, or check payable to Stacy's Studio of Music.*