Clone of 2025-2026 Student Inscription

Student Inscription to the Cello or Piano Sections
Welcome to Suzuki Music Brussels!

Please use this form for 2026-2027 inscriptions only

One form per student and per instrument!
- Siblings must be registered through separate forms
- DO NOT use this form to register for lessons with a violin teacher (even if the intent is to have piano lessons with that teacher). To register for lessons with a violin teacher, please use the "Student Inscription (with Violin Fee)" form.
Have your credit card ready!

Payment of the Suzuki Music Brussels Basic Fee will be required at the end of this form. The 2026-2027 Basic Fee is 48€/year. A reduction may apply if the starting date for lessons is after December.

The Basic Fee does not include the teacher's fee for single lessons, which must be paid separately and according to the teacher's instructions.

SMB fees, once paid, are not reimbursable, unless the inscription is refused by Suzuki Music Brussels.

Student's data
Name of student

FAMILY name first!Given name = prénom/voornaam!
Date of birth of student

DayMonthYear
Day-Month-Year
For which instrument is the student to be registered?
Please confirm:

I understand: i) that only the SMB Basic Fee will be paid through this form; ii) that the Basic Fee covers administrative and rental costs and does not cover any applicable supplementary instrument fee that may be required to cover the costs of events or group lessons specific to the instrument chosen; iii) that the Basic Fee does not cover single lessons, which need to be paid separately and according to the single-lesson teacher's instructions.
With which single-lessons teacher is the student to be registered?
Please contact the teacher and come to an agreement with him / her BEFORE effecting the present inscription). Your chosen teacher may refuse your inscription, if you did not reach an agreement with him / her beforehand. In that case your inscription will either be transferred to another teacher for the same instrument, or, if this is not possible, be cancelled, in which case 90% only of the fees paid with this inscription will be reimbursed.
Please confirm:

Privacy statement and Conditions of Inscription
Privacy Statement:

I understand and I agree that: (i) the present inscription is valid only for the academic year indicated at the top of this form and until the end of the same year; (ii) the information provided here may be stored by Suzuki Music Brussels (hereafter "SMB") for a period of up to 2 years after the end of the period of inscription, but will be deleted thereafter; (iii) the personal data provided here will be used by SMB and its members for internal purposes only and will not be made available to third parties without my explicit consent; (iv) e-mails may be sent by SMB or its members to any or all the contacts provided through this form; (v) some of the e-mails sent by SMB or its members to the contacts provided through this form may not be directly relevant to all the recipients; (vi) information may be sent by SMB or its members to the contacts provided through this form which concerns events or activities not directly linked to or organised by SMB or its members, provided that such information is in all cases relevant to the musical and educational purpose of SMB.

Photo and Video Authorisation
Please choose one of the following options:

I HEREBY GIVE MY PERMISSION to Suzuki Music Brussels (hereafter "SMB") to take photo or video recordings of the student throughout the duration of his/her inscription at SMB, PROVIDED THAT THE FOLLOWING CONDITIONS ARE RESPECTED: (1) any such recording be made exclusively in the context of SMB's pedagogical activities; (2) the legends, titles or other inscriptions on the photos or videos or their material or virtual support will not include any information that could identify the student or his/her family; (3) no such recording or part thereof may be sold or otherwise commercialised in any way; (4) I may at any time ask to verify the use made of such recordings; (5) any such recording may only be used for one or more of the following purposes: i) distribution of the recording to other SMB students who took part in the activities recorded therein and/or to their parents, ii) the promotion of the pedagogical activities of SMB and/or of its members, including through public or social media, (iii) teacher-training activities; (6) I may, by sending an email sent to secretariat@suzuki-music-brussels.be at any time after the end of the student's inscription at SMB, require that any photo or video of the student still held by SMB in which less than 10 persons are visible be either deleted or edited so as not to contain any recognisable image of the student. I understand that, under Belgian law, IF THE STUDENT IS AGED 14 OR MORE, THIS PHOTO AND VIDEO AUTHORISATION WILL ALSO HAVE TO BE GIVEN BY THE STUDENT HIM/HERSELF AND NOT ONLY BY HIS/HER PARENT OR GUARDIAN.I DO NOT GIVE MY PERMISSION to Suzuki Music Brussels (hereafter "SMB") to take or use photo or video recordings of the student; HOWEVER, I understand and accept that under applicable laws SMB MAY NEVERTHELESS TAKE AND USE SUCH PHOTOS AND VIDEOS, PROVIDED THAT (1) the photo or video is or has been taken during a public event; (2) at least 10 persons are visible on any such photo or on each frame of any such video and the way photo or video is taken does not make the student stand out in any particular way. I also understand that SMB voluntarily pledges that the following conditions will be respected: (1) any such recording shall be made exclusively in the context of events directly linked to SMB's pedagogical activities; (2) the legends, titles or other inscriptions on the photos or videos or their material or virtual support will not include any information that could identify the student or his/her family; (3) no such recording or part thereof shall be sold or otherwise commercialised in any way; (4) I will be able at any time to ask to verify the use made of such recordings; (5) any such recording shall only be used for one or more of the following purposes: i) distribution of the recording to other SMB students who took part in the activities recorded therein and/or to their parents, ii) the promotion of the pedagogical activities of SMB and/or of its members, including through public or social media, (iii) teacher-training activities.

Basic Fee Payment

The payment system used by SMB is Stripe.

Please click here if you would like more information on Stripe payment systems.

Mes produits

Basic Fee :€50.00

SPECIFY FOR WHICH TERMS you are effecting the inscription:
Item subtotal:

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Total €0.00

Debit or Credit Card
Prénom	Nom de famille
Numéro de carte bancaire	Code de sécurité
Mois d'expiration	Année d'expiration

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Student Inscription to the Cello or Piano Sections

Please use this form for 2026-2027 inscriptions only

Privacy statement and Conditions of Inscription

Photo and Video Authorisation

Basic Fee Payment

Mes produits*

Mes produits