Musikgarten

Registration

Please read our Policy document carefully before submitting registration and sign our Informed Consent waiver before class.

If you would like to purchase an instrument kit, please indicate your choice in the Comment box below. Add the cost of the kit to your tution when you submit payment.

Select Class:

Preferred Day/Time:	(e.g. Tuesdays 09:30)

Parent's First Name:
Parent's Last Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Email Address:
Home Phone Number:	- -
Work Phone Number:	- -
Cell Phone Number:	- -

Alt. Contact Person:
Alt. Contact Phone:	- -

Child's First Name:
Child's Last Name:
Child's Current Age:	months years
Child's Birthdate:	(MM/DD/YYYY)

List any allergies or medical issues of which the teacher should be aware:


How did you hear about us?:

Other:

Question/Comment: