REGISTER FOR MUSIC LESSONS

Registration Requirements:

1. Your child must live between Jarvis St. to Broadview Ave. and Wellesley St. to Lake Ontario.

2. To complete the registration process, we require families to provide proof of income (monthly gross income from all sources) to determine the cost of lessons. Returning families must provide this information annually for each new school year in September. We do not accept tax statements. All of your information is kept confidential.

You will have the option to enroll up to four children in Dixon Hall Music School. If you are enrolling more than one child, after completing all information for your first child, please hit the NEXT button to proceed with the registration process for your next child. Once you have inputted all your children's information, please hit the submit button on the last page.

Parent/ Guardian Information

Parent/Guardian #1*

Prefix

First Name*

Last Name*

Parent/Guardian #2

Prefix

First Name

Last Name

Address*

City*

Postal Code*

Primary Phone*

Email address

Note: Bills will be sent electronically to your email address if provided.

Preferred Method of Contact*

Phone

Email

Both

Secondary Phone

How many people in your household? *

Including yourself

Language(s) spoken at home*

How did you hear about Dixon Hall Music School?

Do you give Dixon Hall permission to use photos/videos of your children for promotional purposes?*

Yes

No

How many children are you enrolling in Dixon Hall Music School? *

Lesson Fees & Payments

All lesson fees are subsidized and are based on family income and the number of dependents. Upon registration, families will be required to provide an up to date proof of income from all sources to determine lesson rates. This information will be kept confidential.

Child #1

First Name*

Last Name*

Gender*

Optional to provide pronouns: She/Her, He/Him, They/Them, etc.

Age*

Birthday*

DD/MM/YYYY

Student Phone

Only if they have their own cell phone

Student Email Address

Only if they have their own email address

Instrument (1st Choice):*

Instrument (2nd Choice):*

Check one:*

I need to rent an instrument

I own my own instrument

I currently rent an instrument

Does your child take music lessons currently, or has studied music in the past? If yes, where and for which instrument?*

Does your child have any medical (allergies, etc) or mental health conditions, and/or learning disabilities that we may benefit from knowing?*

Child #2

First Name*

Last Name*

Gender*

Optional to provide pronouns: She/Her, He/Him, They/Them, etc.

Age*

Birthday*

DD/MM/YYYY

Student Phone

Only if they have their own cell phone

Phone Email Address

Only if they have their own email address

Instrument (1st Choice):*

Instrument (2nd Choice):*

Check one:*

I need to rent an instrument

I own my own instrument

I currently rent an instrument

Does your child take music lessons currently, or has studied music in the past? If yes, where and for which instrument?*

Does your child have any medical (allergies, etc) or mental health conditions, and/or learning disabilities that we may benefit from knowing?*

Child #3

First Name*

Last Name*

Gender*

Optional to provide pronouns: She/Her, He/Him, They/Them, etc.

Age*

Birthday*

DD/MM/YYYY

Student Phone

Only if they have their own cell phone

Student Email Address

Only if they have their own email address

Instrument (1st Choice):*

Instrument (2nd Choice):*

Check one:*

I need to rent an instrument

I own my own instrument

I currently rent an instrument

Does your child take music lessons currently, or has studied music in the past? If yes, where and for which instrument?*

Does your child have any medical (allergies, etc) or mental health conditions, and/or learning disabilities that we may benefit from knowing?*

Child #4

First Name*

Last Name*

Gender*

Optional to provide pronouns: She/Her, He/Him, They/Them, etc.

Age*

Birthday*

DD/MM/YYYY

Student Phone

Only if they have their own cell phone

Student Email Address

Only if they have their own email address

Instrument (1st Choice):*

Instrument (2nd Choice):*

Check one:*

I need to rent an instrument

I own my own instrument

I currently rent an instrument

Does your child take music lessons currently, or has studied music in the past? If yes, where and for which instrument?*

Does your child have any medical (allergies, etc) or mental health conditions, and/or learning disabilities that we may benefit from knowing?*

Submit

I agree to ensure my child(ren) are aware of their responsibilities as a student, and will practice regularly and attend all weekly lessons if accepted at Dixon Hall Music School. By submitting this registration form, I also agree to receiving Dixon Hall Music School updates and information. *

I agree

This field should be left blank

Parent/ Guardian Information

Child #1

Child #2

Child #3

Child #4

Submit

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