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Student Full Name

Your Instrument
Select Your InstrumentGuitarUkuleleDrumsPianoSingingViolin

Lesson Type
Select your Lesson TypePrivate 20-minutesPrivate 30-minutesGroup 30-minutesPrivate 60-minutes

Account Payer Full Name

E-mail

Mobile

Membership Type
Select your Membership Type1x Term Membership12 Month Loyalty Membership (Discounted Lesson Fees)

Payment Option
Select your Payment OptionOne-Time Payment (Payment of full fees upfront)Weekly Direct Debit (Weekly Direct Debit for 1 Term)Loyalty Membership (Discounted Monthly Direct Debit for 12 Months)

I have read and agree to the Terms and Conditions of commencing lessons with Focus Music. By commencing lessons and signing this acknowledgement, I the account payer, understand I will be liable for any and all fees associated with this membership.
Signature

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