Lesson Registration - Rockness Music

Parent's Name *

First Name Last Name

Student's Name *

First Name Last Name

Second Student's Name (if necessary)

First Name Last Name

Email *

example@example.com

Phone Number *

- Area Code Phone Number

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Student's Experience Level *

Instrument(s) *

Preferred Instructor

Day of Week (1st Preference) *

Preferred Time (1st Preference) *

: Hour Minutes

Day of Week (2nd Preference)

Preferred Time (2nd Preference)

: Hour Minutes

Please note by submitting this form you agree to the following terms:

1. Security, Health, and Safety.

Client will provide at least one representative to be supervising the lesson during the entire engagement. Client warrants that Venue will be of sufficient size to safely conduct the class(es), that Venue is of stable construction and sufficiently protected from weather. Client maintains sufficient personal injury/property insurance for Venue sufficient to cover foreseeable claims.

2. Indemnification.

Client releases Rockness Music, LLC, our Instructors, officers, directors, any parent and subsidiary or other affiliated entities, and its Instructors, from any and all liability and responsibility in any case of personal injury, property damage or loss, injury, accident, or misconduct. In no event shall we be liable to you for indirect, incidental, special, or consequential damages, which are hereby excluded by agreement of the parties regardless of whether such damages were foreseeable or whether either of us has been advised of the possibility of such damages.

Virtual Lesson Registration