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Payment/Cancelation Policy
94 State St.
New London, CT. 06320
860 443-6810 or 860 444-9677
Caruso School of Music
Registration Form


1. Student name_____________________________________________________________ 

2. Parent(s) Name___________________________________________________________

3. Home Phone __________________________Cell Phone_________________________ 

4. Address… Home ______________________________

  _______________________________

_______________________________

Email___________________________________________________


5. Medical Concerns________________________________________________________  

6. Instrument_________________________ Teacher______________________________ 

7. I have read and understand the payment/cancelation policy

Authorized Signature: _______________________________________ 


8. Credit card info_________________________________________________________  

9. Circle a. or b.

  a. I give Caruso Music permission to video tape and photograph concert performances 
  of myself or child for website use.

  b. I do not give Caruso Music permission to video tape and photograph concert  
performances of myself or child for website use.


______________________________________________________________________________________________________________ 
Student Name (Please Print) 

_______________________________________________________________________________ ____________________________ 
Signature of Parent or Legal Guardian Date 

click here to download form