Casual Lesson Billing Form Please enable JavaScript in your browser to complete this form.Student Name *FirstLastParent/Guardian Name (if student 16 or under)FirstLastEmail *Phone *Instrument of Choice (e.g. vocals, piano, violin, etc.) *Borrow or Bring Instrument *Borrow for lessonsBring to lessonsThis selection is especially relevant to students choosing instruments such as the violin or guitar. Obviously it is not particularly relevant to piano or vocal students. For hygiene reasons, Melodique does not loan brass or woodwind instruments. N.B. We loan instruments for in-lesson use only. If you need to purchase or rent an instrument for at home practise we can advise on where and how to arrange it externally – just ask!Online or In-studio *OnlineIn-studio (Online in the case of covid exposure or government mandated isolation)Melodique’s online options mean that we have always been and will continue to be ALL-INCLUSIVE. We welcome students of all ages and stages from all over the world!Available Items *Melodique Casual Lesson 30-min inc. GST – $50.60Melodique Casual Lesson 60-min inc. GST – $101.20Total Amount$0.00Stripe Credit Card *CardName on CardT&C acknowledgement *I have read and agree with the Melodique Terms and Conditions.https://www.melodique.com.au/refund-returns-cancellation-policy/Signature in agreement to Melodique’s T&Cs *Clear SignatureAcknowledgement of online lesson clause in T&Cs *I acknowledge – as is stated in the Melodique T&Cs – lessons cancelled outside of the 24hr notice period, must be accepted as an online service via Zoom or the fee forfeited. (Lessons cancelled with minimum 24 hr notice can be rescheduled without fee forfeit.)In response to the COVID-19 pandemic Melodique has had to adapt our processes in consideration for our tutor’s time and dedication to attending your lesson booking/s. Note during lockdown periods in the past, our school functioned as a fully online tutoring facility to all child and adult students of every age and stage without disruption to their progress. We are proud to be able to continue to deliver our services in this way in any case of coronavirus exposure or government mandated isolation. As representatives of the music industry, we appreciate your support and understanding in this.Date / Time of Booking (as already discussed with Melodique) *DateTimeSubmit