Valley of the Sun Suzuki Association Group Lesson Registration
Complete 1 form per child – visit our website www.valleysuzuki.org

Private teacher fills out this portion:  Instrument – Violin   Viola    Cello

Student_______________________ Teacher__________________________

Current working piece____________________________

Class 1_________________ Class teacher_________________ Room_______

Class 2_________________ Class teacher_________________ Room_______

Parent fills out this portion:    Student age___________

_____If all other information is the same as Pre-registration, check here and go to payment portion

Parents____________________________ Phone (           )__________________

Address_________________________________ City__________ Zip________

E-mail__________________________________

Payment Portion and Photo Release:
I understand that active participation on my part is an expected part of my child’s participation in these lessons.  Photo release: VSSA may use any photos taken during group lessons, workshop, or performances for use on web-site.
I understand that due to fixed expenses, all tuition is NON-REFUNDABLE.

Parent Signature____________________________________ Date___________

Payment Options – please check the appropriate box

One payment, due upon registration - $185 ($100 if pre-registered)

Two Payments  - 2 checks, $92.50 each ($50 each if pre-registered)
If you choose the two payment option, TWO checks must be submitted upon registration, one with the current date and one post-dated November 1.

Make all checks payable to VSSA.

Discuss class placement with your teacher to fill in top portion.
Bring form to first group lesson to turn in with your payment!