Darien Arts Center Class Registration Form (Music)

Fill out the form below, print it, SIGN IT, and send it in with your payment. Mail it to:
  • The Darien Arts Center
  • 2 Renshaw Road
  • Darien, CT 06820
 or fax to 203-655-9470
If faxing, add credit card number and expiration date, otherwise leave credit card fields empty.
Name: Male Female
Age: Grade: Birth Date:
Address:
Town: Zip Code:
Parent's Name: Email:
Phone - Home: Work/ Cell: Emergency:
Instrument: Instructor: Day: Time:

Private Lessons
PRIVATE LESSONS
FALL TERM
September - December
15 weeks, one lesson per week
WINTER/SPRING TERM
January - June
20 weeks, one lesson per week
SUMMER TERM
June - July
6 weeks, one lesson per week
No Classes Scheduled During Darien
School vacation Weeks.		   Number of
Lessons
per term 		Number of
Pro-rated
Lessons		 Total
Number
of Lessons		 Price
per
Lesson 		Total
Half hour lessons $40
45 Minute lessons $60
One hour lessons $80
Registration Fee: $20
    Total Tuition:
PRO-RATING
You may prorate a maximum of two lessons per term in addition to any pre-arranged teacher absences and or any DAC holiday conflicts.

After confirmation of instructor, lesson, day, time, and location, please make your check payable to the DAC and mail to:
The Darien Arts Center, 2 Renshaw Rd., Darien, CT 06820
I understand all lessons must be paid for in advance whether taken or missed, If a lesson is cancelled due to teacher illness, etc., every effort will be made to make it up. Unfortunately we are unable to give make up classes for student absentees.
  Signature:  
Credit Card: Number: Exp: