Registration Form

Please Print Clearly

Submit one form per student.

Yes, I have read and understand all Policies and Procedures regarding classes and enrollment.

Initial
Please check the appropriate boxes.
Office Use OnlyPDM
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New Family Returning Family
REGISTERING FOR:
SEMESTER Fall Winter Spring Summer 20 Year
Musical Baby Pretoddler Fun Musical Beginnings Family Music Time
SEMESTER Fall/Winter Winter/Spring Summer 20 Year
Imagine That! Kindermusik Young Child I (glockenspiel class)
YEAR TERM CLASS School Year (30 weeks) Summer 20 Year
Instrumental Music Exploration Music Majors
1st year keyboard		 Music Masters
2nd year keyboard
Music Maestros
3rd year keyboard		 Music Composers
4th year keyboard

 

1st Choice of Class Day: Time:
2nd Choice of Class Day: Time:
3rd Choice of Class Day: Time:

 

Best Email Address to receive class confirmation and important class information/updates
Child's Full Name:Date of Birth
Mother's Full Name: Daytime Phone:
Father's Full Name: Daytime Phone:
Caregiver's Full Name: Daytime Phone:
Home Street Address:
City State Zip
Home Phone Cell Phone Other Phone
Where did you first here of The Center for Music, Movement & Art Classes?
FAMILIES magazineWASHINGTON PARENT magazineLocal Library
Family MemberFriendWord of MouthOther
Enclosed payment is: Class Payment
Sibling Fee
More than one class a week. Each additional class is the same as sibling fee. 2x  3x
Total Payment

 

Enclosed separately is my tax deductible contribution.

Please note that your place in the class is reserved only with Full Payment and a complete Registration Form. Send form and payment to:
The Center for Music, Movement and Art, Inc.
P.O. Box 342310 Bethesda, MD 20827-2310