General Information

Child's Name

Child's Birthday

Child's Age

Name of Parent(S) / Guardians

Daytime Phone

Cell Phone

Email

Street Address

City

State

Zip

Medical or special needs? Allergies?

How did you hear about this kindermusik studio?

Class Information

Please indicate your preferred day and time – refer to class schedule on home page

(1st choices will be honored as space permits)

1st choice

2nd choice

3rd choice

An invoice will be emailed to you after registration is confirmed. We accept credit card, check or cash paid in full at your 1st class