About Our Teacher

REGISTRATION 2020-2021

Student Name:

Guardian Name (if applicable):

Student’s Email: _

Parent/Guardian’s Email:
NOTE:    Newsletters are sent out electronically regularly. Please print your email clearly and add
               ispleit@hotmail.com   to your email’s safe list so that newsletters are not filtered into your junk mail.

Phone #:     Alternate Phone #_______________________________________

Birthdate and year:    __________________________

School Grade in Sept 2020: ___________________

Address: _________________________________________________________________    City: ________+

Emergency Contact Name: ___________________________________________________________    Phone #:

Allergies/Medical Concerns: _________________________

FEES : (Sept 2020-June 2021)    Please choose one option per person: I accept e- transfer at ispleit@hotmail.com
1st Family Member:
□ Option 1: Received by June 20/20    $400 ($400)
□ Option 2: Received by June 20/20 $100. PLUS: One cheque dated Sept. 1 for $320.    ($420)
□ Option 3: Received by June 20/20 $100. PLUS: Two cheques, dated Aug . 1/ Sept.1 for $160. each ($420)
□ Option 4: Received by June 20/20 $100. PLUS: Four cheques, dated July 1/Aug.1/Sept.1/Oct.1 for $80.    ($420)
              ALL CHEQUES DUE BY JUNE 20/20 and PAYABLE TO ILONA SPLEIT
2nd/3rd Family Member:                                   Please choose one option:
□ Option 1: Received by June 20/20    $380 ($380)
□ Option 2: Received by June 20/20    $50   PLUS: One cheque, dated Sept. 1 for $330. ($380)
□ Option 3: Received by June 20/20    $50   PLUS: Two cheques, dated Aug. 1st & Sept. 1 for $165.    ($380)
□ Option 4: Received by June 20/20    $50   PLUS: Four cheques, dated Aug 1, Sept.1,Oct 1, Nov.1 for $82.50 ($380)
         ALL CHEQUES DUE BY JUNE 20/2019 and PAYABLE TO ILONA SPLEIT
*    Deposit will reserve your place in your class/ensemble and enable continuing students to keep their instrument over the summer months. Deposit is non-refundable. Refunds on the remainder of lesson fees will be pro-rated up until Nov.30th only. No refunds will be given for students who discontinue with the program after Dec.1st, 2020.
** Fee includes: weekly class lesson and weekly orchestra lesson; Sept-June free instrument loan. (Video and Zoom lessons during Covid -19)
***Cheques payable to: “Ilona Spleit ”- Cheques returned NSF will be subject to a $25 charge.

The Spleit Strings Studio provides a free instrument loan to all students participating in the group programs. The student and/or guardian accepts responsibility for the loan of the instrument and recognizes that any damage incurred will be their financial responsibility. Damages include but are not limited to broken strings, cracks and scratches on the instrument, damage to the case, lost instrument covers, warping of the bow or significant hair loss on the bow. Any necessary repairs should be completed as soon as possible. The loan of the instrument is granted to the student only while they are involved in the program. Upon discontinuation of lessons, the instrument must be returned immediately, in the same condition as it was received.

Parent/Guardian/Student (if over 18)’s Name: (please PRINT)

Parent/Guardian/Student (if over 18) signature:

Registration forms can be delivered or mailed to:
Ilona Spleit / Spleit Strings Studio 222 Grosvenor Ave S. Hamilton Ont. L8M 3L9
or E- mailed to ispleit@hotmail.com
WWW.SPLEITSTRINGS.COM    905 512 9945