Registration

To register for either of the classes, you can copy/paste this form into an email to Lissa at lap627@yahoo.com.  (I can get the signature the first night of class.)

Registration for MUSIC, MOM, and ME! and MUSIC MOVES ME!

Name of Child:  __________________________________

Age:  _____________

Which class are you registering for? (Circle One)

  Music, Mom and Me (ages 2-3)     

               Name of Parent who will attend with Child: _____________________

  Music Moves Me!  (ages 4-5)

Parents’ Names:  ____________________________________

Home Phone:  ______________________________________

Cell Phone:  ________________________________________

Email Address:  _____________________________________

Is there anything you would like me to know about your child?  (Personality/health issues/fears?)

______________________________________________________________________________

______________________________________________________________________________

I, ______________________________, have read the class description and schedule and would like to register my child.  I understand that by signing this form, I am reserving my spot in the class and that payment is due in full on the first night of class.  No payment will be reimbursed unless there is an emergency. 

_______________________________________

                                Parent Signature

*Siblings of class age registering will receive 50 percent off one registration. 

*Siblings over 1 year old age not eligible for a class due to age may attend at half price.  Please include their name on the registration form.  (One year of age and under can come for free.)