Let's get started!

Are you registering for lessons online or in person? *

Student Information

Student 1 Full Name *

Student 1: Date of Birth *

Student 1: Instrument *

Student 1: Length of Lesson *

If you don't have another student to register, skip to the Availability section -->

Student 2

Student 2: Full Name

Student 2: Date of Birth

Student 2: Instrument

Student 2: Length of Lesson

Student 3

Student 3: Full Name

Student 3: Date of Birth

Student 3: Instrument

Student 3: Length of Lesson

Availability

Please include all the availability you have for lessons in your home each day of the week. Include as much availability as possible to help us pair you with a teacher best, and you may also include any preferences as well.

*We require a minimum of 3 days and 8 hours of availability - the more you offer, the faster and more likely we can pair you with the most ideal teacher 😃

Mondays *

Tuesdays *

Wednesdays *

Thursdays *

Fridays *

Saturdays *

Sundays *

** Please check - did you include at least 3 days of availability and at least 8 hours?

Start Date

Please select and write out which of the following you prefer:

Start Asap: We usually can set schedules to begin within 2-4 weeks for students registering throughout the year.
Start at the next semester: See below to know our semester days for this year.
Please enter a specific start date: If you are hoping for a specific start date, please let us know that.

Summer Semester June 15 - Aug 10

Fall Semester Aug 18 - Dec 21

Spring 2025 Semester Jan 5 - June 14

Students can begin anytime.

Account Holder - Parent Information

First Name *

Last Name *

Phone *

Email *

Emergency Contact

Please enter the name of a second adult in the home whom we can contact if there is an emergency or issue and you can't be reached:

2nd Adult's Name *

2nd Adult's Phone Number *

Your Address

Address Where Lessons Will be Held *

If there is a gate code your teacher will need to access your home, please enter:

City *

State *

Postal code *

Almost there!

May we use videos or photos of your child/children in our promotional materials online or in print? *

Yes

How did you hear about us? *

Promo Code?

Do you have a government scholarship to pay for lessons? If so, please enter the name of the scholarship you have:

Please read and agree to our policies: https://shiningstarmusicacademy.com/policies-1

Do you agree to our policies shared above? *

Yes

I agree to abide by the 30 day notice policy to stop lessons, pause, or change my lesson schedule. I understand that the final month of lessons may be prorated based on when I gave a 30 day notice. *

I agree

I agree to set my account on autopay or to pay manually by the 8th of each month , or there will be a $50 late fee applied per 30 days late. *

I agree

I agree to our lesson attendance policies: if I cannot make a lesson, I can choose from an online lesson at the same day and time, a video lesson to be made for the student, or to attend a group online makeup lesson during the month. I will not receive a rescheduled makeup for lessons I cannot attend. *

I agree

I understand that I will need to save the Student App on my device and use that for cancelling lessons and signing up for performances or events. *

I understand

Please share your goals for the student, any experience they have had in their instrument, and other notes that would assist us in helping you find the best teacher:

If this form is being filled out by a company representative, please share your name:

Press the "submit" button and you will be required to pay a $50 deposit per family on the next screen.

NOTE: If the "submit" button isn't working, a box wasn't filled in correctly. Please scroll to the top of the form to see how to solve the issue

!! If you don't receive an email confirmation after submitting this form, it did not go through!

email us at [email protected] if you have issues or call 352-519-3999

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.