Student's Name *

First Name

Last Name

Student's Date of Birth *

MM

DD

YYYY

Parent/Guardian Name *

First Name

Last Name

Phone

(###)

###

####

Class *

Which program are you interested in?

Toddler Tunes (ages 18m–3)

Hello Music (ages 3.5–4)

Music Time (ages 4.5–6)

Young Musician Intro (ages 6.5–8)

Session *

Which session(s) would you be available for?

Session 1: June 17–28

Session 2: July 7–19

Session 3: August 5–17

Time *

What is your preferred class time window?

Mon/Wed – Morning (9:00 AM – 12:00 PM)

Mon/Wed – Afternoon (12:00 PM – 5:00 PM)

Mon/Wed – Evening (5:00 PM – 8:00 PM)

Tues/Thurs – Morning (9:00 AM – 12:00 PM)

Tues/Thurs – Afternoon (12:00 PM – 5:00 PM)

Tues/Thurs – Evening (5:00 PM – 8:00 PM)

Saturday – Morning (9:00 AM – 12:00 PM)

Saturday – Afternoon (12:00 PM – 5:00 PM)