Music Together with Madeline

Below is a form you can fill out to register for one of my classes.

Tuition is $175.00 for the first child,$140.00 for the second child, $115.00 for the third child.Tuition includes 2 CDs, a songbook, and activity suggestions for parents. Infants 8 months and under are free when attending with a paying sibling. Refunds are not available after the first class, but make-ups can be arranged based on availability. There is a registration fee of $15.00 for new families only.

I will confirm your registration once I have received payment.

* Your First Name:
* Your Last Name:
*Mailing Address:
*City:
*State/Province:
*Zip:
*Phone:
Other Phone:	Type (work, cell, etc):
*Email:	Contact Preference:

Registrants

	First Name	Last Name	Date of Birth (mm/dd/yy)
Child #1
Child #2
Child #3

Class 1^st Choice

Location:	Class Type:

*Class:
<Select Location and Class Type first>

Class 2^nd Choice — Please select a second class in case your first choice is unavailable.

Location:	Class Type:

Class:
<Select Location and Class Type first>

Waitlist OK?
YesNo

Comments:

How did you hear about us:

* - Required information.

Class 1st Choice

Class 2nd Choice — Please select a second class in case your first choice is unavailable.

Class 1^st Choice

Class 2^nd Choice — Please select a second class in case your first choice is unavailable.