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PAYOR'S AUTHORIZATION FOR PRE-AUTHORIZED DEBITS (PAD), VISA OR MASTERCARD PAYMENTS FOR MUSIC LESSONS THROUGH KLM STAGE AND MUSICIAN SERVICES LTD.








Please charge the following amount PER STUDENT being enrolled for the KLM Rocke School/Group Lessons Program using one of the following payment options.

Payment Method

Please Select A Payment Method

Pre-Authorized Payment Type *

DebitCredit CardI have already provided my payment information

Pre-Authorized Withdrawals (Secured)

Payor's Financial Institution Information (the 'Processing Information')







Credit Card Payment Information (Secured)

Sorry, Visa Debit or MasterCard Debit cards not accepted at this time.




**You will NOT automatically be charged by entering payment information, it will allow us to set up billing according to the arrangements we make with you.**

I/We will inform the Payee, in writing, of any change in the information provided in the above section of the Authorization prior to the next due date of the PAD, VISA or MASTERCARD Payment.


Service Agreement

Please read the following Service Agreement and Terms and Conditions, ensuring that you check the box for each, indicating that you have read and agree with them.

View Service Agreement *

  1. Payor's Name and Address. I/We warrant and represent that the information provided is correct and accurate.
  2. Payee's Name and Address

    KLM STAGE AND MUSICIAN SERVICES LTD.
    Suite 95, 4511 Glenmore Trail SE
    Calgary, AB T2C 2R9
    Phone: (403) 210-3339
    Fax: (403) 287-3315

  3. I/We acknowledge that the Authorization is provided for the benefit of the Payee and the Processing Institution and is provided in consideration of the Processing Institution agreeing to process debits against my/our account, as listed above, (the “Account”) in accordance with the Rules of the Canadian Payments Association.
  4. I/We warrant and guarantee that all persons who submit this electronically or whose signatures are required to authorize withdrawals from the Account have signed the Authorization below.
  5. I/We hereby authorize the Payee to issue Pre-Authorized Debits (as defined in Rule H4 of the Rules of the Canadian Payments Association) (the “PAD”) drawn on the Account, VISA or MASTERCARD for the following purpose: ROCK SCHOOL/GROUP LESSONS
  6. I/We may cancel the Authorization at any time upon providing written notice to the Payee.
  7. I/We acknowledge that provision and delivery of the Authorization to the Payee constitutes delivery by me/us to the Processing Institution. Any delivery of the Authorization to the Payee, regardless of the method of delivery, constitutes delivery by me/us.
  8. The Payee will provide to me/us, at the address provided in Section 1:
    1. with respect to fixed amount PADs, written notice of the amount to be debited (the “Payment Amount”) and the date(s) on which the Payment Amount debited will be posted to my/our Account (the “Payment Date”), at least 10 calendar days before the Payment Date of the first PAD, and such notice shall be provided every time there is a change in the Payment Amount or the Payment Date(s);
    2. with respect to variable amount PADs, an annual calendar of the Payment requirements and the Payment Date(s) based on the number of lessons in each pay period is supplied in this package; and
    3. with respect to a PAD plan that provides for the issuance of a PAD in response to a direct action of mine/ours (such as, but not limited to, a telephone instruction) requesting the Payee to issue a Pad in full or partial payment of a billing received by me/us for a payment obligation that meets the requirements of Section 2 or Rule H4, no notice is required.
  9. I/We acknowledge that the Processing Institution is not required to verify that a PAD has been issued in accordance with the particulars of the Authorization including, but not limited to, the amount, or that any purpose of payment for which the PAD was issued has been fulfilled by the Payee as a condition to honouring a PAD issued or caused to be issued by the Payee on the Account.
  10. Revocation of the Authorization does not terminate any contract for goods or services that exists between me/us and the Payee. The Authorization applies only to the method of payment and does not otherwise have any bearing on the contract for goods or services exchanged.
  11. I/We may dispute a PAD only under the following conditions:
    1. the PAD was not drawn in accordance with the Authorization;
    2. the Authorization was revoked; or
    3. pre-notification, as required under Section 8 was not received.

    I/We acknowledge that in order to be reimbursed a declaration to the effect that either (1), (2) or (3) took place, must be completed and presented to the branch of the Processing Institution holding the Account up to and including 90 calendar days after the date on which the PAD in dispute was posted to the Account.

    I/We acknowledge that when disputing any PAD beyond the time allowed in this section, it is a matter to be resolved solely between me/us and the Payee, outside the payments system.

  12. I/We agree that the information contained in the Authorization may be disclosed to Royal Bank of Canada as required to complete any PAD transaction.
  13. I/We understand and accept the terms of participating in this PAD plan.

I Have Read and AGREE with the KLM Service Agreement *

Terms and Conditions

Please Read Our Cancellation Policy Carefully

Cancellation Policy

Student cancellations: NO REFUNDS OR MAKEUPS WILL BE GIVEN FOR LESSONS CANCELLED BY STUDENTS. In order for KLM Music to attract and keep quality instructors, we need to be respectful of the time they set aside in their weekly schedules to teach. In the event that a teacher may be willing to do the occasional makeup lesson, it should be viewed as the exception and not the rule.

Teacher cancellations: In the event that a teacher may need to cancel a lesson, the lesson will be made up. Alternate teachers may be used to do makeup lessons. In the unlikely event that a teacher cancellation cannot be made up, a refund will be issued.

I have read and AGREE with the Cancellation Policy *

Non-Solicitation Clause
The client acknowledges that the music instructor provided by KLM is at the core of business for KLM and that the music instructors who provide this service are key and instrumental to KLM. The client, therefore, will not privately solicit, entice, hire or contract any KLM music instructor for a period of 12 months following the end of our service agreement.

Returned Items Policy (NSF)
All returned payments will be assessed an additional $20.00 service charge.

I Have Read and AGREE with the Terms & Conditions *
I agree to receive Commercial Electronic Messages from KLM Music Ltd. * Learn More