Registration Form for Lessons and Classes in Hokah for the Fall Session

Parent Name: Student Name:

Address: Phone:
Email: Alternate Phone:
Lessons 13 weeks Monthly Amt Session Amt Your Total
Classes 11 weeks (3 payments)
30 Minute Lessons $65 $195
Acting Fun grades 1-4 - 60 min. $20 $60
Acting 101 grades 5-6 60 min. $20 $60
Acting 101 grades 7-8 60 min. $20 $60
Adult Music Jam - 60 min. N/A $20
Music Fun Oct.-Dec. grades 1-4 N/A $40
Vocal Coaching (at least 2
sessions)
$25 per session (60
min)
Times 2,3,4 or 5 =
TOTAL ------------------------------ --------------------------- =
Less Family Discount
10% per additional
child
10% per additional
child
-
TOTAL (less discounts) ------------------------------- ------------------------------ =
New student Registration fee ------------------------------- $30 +
TOTAL
--------------------------------
-------------------------
=

A $25 deposit is required by Wednesday, September 3 to reserve a spot.

Those who choose to pay monthly must bring their payment on the first week of each following month
until the balance is paid. Late fees will be assessed if payment is not received on time.

Do you give permission for your child to be photographed for promotional materials?
Yes / No Signature of parent/adult student _______________________________________
Did you read the Academys policies and agree to them?
Yes / No Signature of parent/adult student ________________________________________
PO Box 184, Hokah, MN 55491
Phone: 608-397-0206
Email: lacrescent.arts.academy@gmail.com
Web: lacrescent-hokah-arts-academy.weebly.com