Kindermusik Class Enrollment

Please use this SECURE form to register for a class. If choosing to pay by credit card, your card will NOT be charged directly from this page. Your total fees and payment schedule will be noted in your mailed registration confirmation.

Parent or Guardian

First Name

Last Name

Address

Street

City

State

Zip

Cell Phone

Child #1

Child's First Name

Child's Last Name

Birth Date

Sex

Class - First Choice

Class Level

Day

Time

Class - Second Choice

Class Level

Day

Time

I have taken this particular unit before with an older child, so my home materials choice is:

Child #2

Child's First Name

Child's Last Name

Birth Date

Sex

Class - First Choice

Class Level

Day

Time

Class - Second Choice

Class Level

Day

Time

I have taken this particular unit before with an older child, so my home materials choice is:

Please let us know of any pertinent medical or behavioral conditions:

Note: If registering more than two children, please list subsequent children's name and class choice in Comments box (bottom of form)
Credit Card Information

How did you hear about us?

If friend or family, whom may we thank?

Comments or Questions

Name on Credit Card

Credit Card Number

Expiration Date

CVC

Please confirm that you have read the following: *
information will not be released to any third party, and is for the exclusive use of communication from Musical Beginnings. You have my permission to use photographs or video of myself or my child taken at Musical Beginnings classes or special events. I understand names will not be used without my permission. With this enrollment, I release any and all rights and claims for damages against Musical Beginnings and its Staff in the unlikely event of injury sustained by myself or my child(ren) during the course of or as a result of my enrollment at Musical Beginnings.

I have read and agree to abide by the policies of Musical Beginningsas stated above.

I Agree