Parent's Name (if under 18) Student's First Name Student's Last Name Email Address Phone Number Select Number of Classes You Would Like to Upgrade to Per Week (required) - please note an additional family member discount of $1/lesson will be automatically applied if you meet the requirements for it —Please choose an option—30 minute class x 2 ($31/wk)45 minute class x 2 ($33/wk)60 minute class x 2 ($35/wk)60 Minute Class x 1 and 45 minute Class x 1 ($34/wk)Unlimited Classes of Any Type($47.5/wk) Should the change start this week or next week? (weeks run from Monday-Sunday) Starting This WeekStarting Next Week How Long Should We Make this Change For? - If let blank we will change the membership until you email us to change it back Until I Change it Back by Sending an EmailUntil the Main Gradings on the 15th/16th of NovemberUntil the Make Up grading on the 22nd of November I am aware my payments for classes will be altered according to the form above