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Registration Form Scribd

This registration form collects parent and child information for music classes. It requests the parent's contact details and emergency information, as well as how the parent heard about the classes. The class schedule provides the days and times of available classes. Payment information is also collected, including whether payment will be by cash, check, or credit card. Permission is requested to use photos of enrolled children on the studio's website and materials.

Uploaded by

Morgan May Sparks
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
159 views1 page

Registration Form Scribd

This registration form collects parent and child information for music classes. It requests the parent's contact details and emergency information, as well as how the parent heard about the classes. The class schedule provides the days and times of available classes. Payment information is also collected, including whether payment will be by cash, check, or credit card. Permission is requested to use photos of enrolled children on the studio's website and materials.

Uploaded by

Morgan May Sparks
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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REGISTRATION FORM

PARENT INFORMATION
Parent Name:____________________________________
Address:________________________________________
City: ____________________State:____ Zip:_________
Home Phone: ___________________________________
Work Phone: ____________________________________
Cell Phone: _____________________________________
Email Address: __________________________________
Emergency Contact: ______________________________
Emergency Phone: _______________________________
How did you hear about us? ________________________
Referred by: ____________________________________

CLASS SCHEDULE
INFORMATION
CLASS SCHEDULE
Classes are filled on a first registered, first served
basis. Please register early to assure a place in the
class of your choice.
All classes begin the week of January 16, 2012
Village:
Our Time:
Imagine That!:
Young Child 4:
Family Time:

MON 5:30 p.m.


MON 6:15 p.m.
MON 7:15 p.m.
MON 4:30 p.m.
THURS. 6:30 p.m.

Birthday Parties and Playshops available


upon request.
Please schedule at least 2 weeks in advance.
Referral Reward
If your friend signs up for this semester and lets me
know that you referred her, both of you receive $10
off your next semester.
Other discounts are available. Please see website,
www.rhythmgardenmusic.com for more details.

Rhythm Garden Music Studio


266 E Main Street
Jasonville, IN
798.1200
[email protected]
www.rhythmgardenmusic.com

CHILD INFORMATION - 1
Child Name: ____________________________________
Child DOB: _____________________________________
Desired Class:___________________________________
Alternate: ______________________________________
CHILD INFORMATION - 2
Child Name: ____________________________________
Child DOB: _____________________________________
Desired Class:___________________________________
Alternate: ______________________________________

METHOD OF PAYMENT
( ) Cash ( ) Check ( ) Other ___________________
( ) Visa ( ) MasterCard
Card Number: ___________________________________
Expiration Date: _________________________________
Name on Card: __________________________________
Signature: ______________________________________
(Signature authorizes charges for class fees and home
materials, less any applicable discounts.)
*Please make checks payable to Morgan May.
I give Rhythm Garden
Musicyou!
Studio permission to use
Thank
classregistration
photos of mywill
child
website and/or
print
Your
beonconfirmed
within
one
advertising
materials.
week.
(please circle one)
Yes
No
In the event that a class is cancelled due to weather,
illness, emergency, etc., I may be contacted via the
STUDIOfollowing:
INFORMATION
(please
circle all
apply)
Kindermusik
withthat
Morgan
Email
Text
266 EMessage
Main Street Phone Call

Jasonville, IN
847.0795
[email protected]
Thank you!
kmwithmorgan.kindermusik.net
Your registration will be confirmed within 1 week.

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