Registration Form and Acceptance of the CAM Agreement

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Registration Form and CAM Agreement

Registration Form and Acceptance of the Chopin Academy of Music Agreement

2023-24 CAM Agreement

2023-24 CAM Calendar

The form must be filled out by a parent, legal guardian, or student of 18 or more years of age. One registration and acceptance form may be submitted for all students within a family, but constitute separate and individual agreements under the terms of the 2023-24 CAM Agreement associated with the choice of registration made below. Individuals taking instruction under multiple teachers must re-enter their names in order to select each teacher. Likewise, each instance constitutes a separate and individual agreement.

Note that the "Exam Track" option for 2023-24 registration will be unavailable after September 30, 2023.

Student #1 (required)

Student Name *

Enter student name #1. Enter names below for additional registered students within your family. Note that each entered name constitutes a separate registration in terms of the 2023-24 Agreement.

Date of Birth *

mm/dd/yy

Lesson Duration (in minutes) *

Instructor #1 *

Exam Track? *

Whether or not you intend to take exams (exam-track) for the 2023-24 academic year (note that "Yes" will be disabled after Sept 30, 2023). A minimum of 45-minute lesson duration is required to be enrolled, plus obtain the permission of one's primary instructor.

Student #2 or Instrumental Lessons #2 (if applicable)

Name

Date of Birth

mm/dd/yy

Lesson Duration (in minutes)

Instructor #2

Exam Track?

Student #3 or Instrumental Lessons #3 (if applicable)

Name

Date of Birth

mm/dd/yy

Lesson Duration (in minutes)

Instructor #3

Exam Track?

Student #4 or Instrumental Lessons #4 (if applicable)

Name

Date of Birth

mm/dd/yy

Lesson Duration (in minutes)

Instructor #4

Exam Track?

Family and Parental Contact Information

Parent or Legal Guardian *

Enter the name of the parent or legal guardian. Adult students, age 18 or over completing this registration may enter their own name or "N/A" in both fields.

Email *

Primary Telephone *

Mobile or Work Telephone

Address *

Country

City

State

Zip code

Lesson Slot *

Please enter a date(s) between now and August 31, 2024 if known and time slot for the lesson(s) time (note, September 5, 2023 is the first normal teaching day of the 2023-24 academic year). Agree with the primary instructor on date and time before entering here.

Referral?

Did anyone refer you to the Chopin Academy? If so, please let us know their name.

Notes to instructor

This may include things helpful for a teacher to know, such as number of years of lessons with other teachers, goals, particular learning needs, etc.

Registration is for (click one) *

2023-24 Introductory period (beginning Sept 1, 2023)

2023-24 Full Registration (beginning Sept 1, 2023)

Payment Options

Payment Method *

Paper check (must arrive by the deadline; avoids processing fee)

ACH or credit card (3% convenience fee added)

Enter your desired payment transaction method. For all credit card and ACH deposit options, a 3% convenience fee will be added to each transaction.

Payment Frequency *

Period installment (due Sept 1, Nov 1, Jan 15, and Apr 1)

Monthly installment ($5 per payment fee applies)

Select your preferred frequency of payment. Periodic installment (4) due dates are Sept 1, Nov 1, Jan 15, and Apr 1. Monthly installment deadlines are the first of each month, September through June; the first payment includes first and last month's (July) in addition to annual fees. A $5 per payment fee applies to the monthly payment option.

Agreement *

I agree to the terms and conditions below

Registration Form and Acceptance of the 2023-24 Chopin Academy of Music Agreement

The form must be filled out by a parent, legal guardian, or student of 18 or more years of age. Each entered name represents a wholly separate and individual entry of registration as it pertains to the 2023-24 CAM Agreements.

By clicking the submit button, you affirm that you are of legal adult age, the registered student named above, or the parent or legal guardian of the registered student named above. You agree to accept all terms and conditions of the 2023-24 Chopin Academy of Music Agreement (hereinafter referred to as “Agreement”) pertaining to the registration period selected above.

Furthermore, you are agreeing to the following:

1) This Agreement supersedes any prior written or oral Agreement, contains the entire Agreement, and there are no other promises or conditions in any other Agreement whether oral or written;

2) This Agreement may be modified or amended by the CAM;

3) In the event that the CAM requires the services of an attorney in connection with enforcement of this Agreement, or in the event that litigation is commenced, the prevailing party shall be entitled to reasonable attorney's fees;

4) If any provisions of this Agreement are held to be invalid or unenforceable, the remaining provisions shall continue to be valid and enforceable. If a court finds that any provision of this Agreement is invalid or unenforceable, but that by limiting such provision it would become valid and enforceable, then such provision shall be deemed to be written, construed, and enforced as so limited;

5) Failure of the CAM to enforce any provision of this Agreement shall not be construed as a waiver or limitation of the CAM\'s rights to subsequently enforce this Agreement;

6) This Agreement shall be governed by the laws of the state of Washington and venue shall lie in King County; and

7) This Agreement may be executed in any number of counterparts, all of which shall be deemed to be an original and constitute a single Agreement. An electronic transmission bearing any person's acceptance of the terms and conditions shall have the same force and effect as the original of this Agreement bearing such person's signature.

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