Parent/Caregiver 1 Name *

First Name

Last Name

Parent/Caregiver 2 Name

First Name

Last Name

Child's Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Child 2 Name (sibling registration only)

For siblings over 8 months old. Sibling tuition is $135 ($40 discount). Please choose "deposit only" payment option on the next page to register 2 children.

First Name

Last Name

Child 2 Date of Birth

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Caregiver 1 Phone Number *

(###)

###

####

Caregiver 2 Phone Number

(###)

###

####

Have you registered for Music Together before? *

yes, I have taken a class with Music Together @ MCMA

I have attended Music Together classes at the library

no

How did you hear about us? (Select as many as you like.) *

Newsletter

Instagram

Facebook

Newspaper

Online Search

Word of Mouth

Attended Class Before

Poster/Flyer

Other

Please note: payment (deposit or in full) is required to save my child's slot in class *

I understand

media permission *

I give permission to take photos and/or video of my child. I grant permission to use the images resulting from the photography/video for fundraising, publicity or other purposes to help achieve MCMA's aims.

yes

no