Rattle and Roll Online Registration

Registration

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Welcome to Rattle and Roll- multi-award winner for BEST BABY MUSIC CLASS! Please complete the following registration form. If enrolling more than one child, first create a record of information for him/her ("Add another student"), AND ALSO CLICK ON "ENROLL IN CLASSES" TO REGISTER THE SECOND CHILD FOR THAT CLASS. Rattle and Roll processes tuition payments prior to the start of each session. Please check for credit card accuracy.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Contact #1

Contact #1 First Name*

Last Name *

Relationship to student(s)*

How Can We Contact You?

Home Phone

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Birth Date*

Please click on the Search button below, and choose the class you want. If you are waitlisted for that class, please also register for a 2nd choice, if desired. DON'T FORGET TO INCLUDE IN THE "COMMENTS" SECTION BELOW HOW MANY INSTRUMENT KITS YOU WOULD LIKE TO ORDER (one for you, one for your child).

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

Registration

Family Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Student #1

Enroll in Classes

Student #2 (Show-Hide Details)

Enroll in Classes

Student #3 (Show-Hide Details)

Enroll in Classes

Student #4 (Show-Hide Details)

Enroll in Classes

Student #5 (Show-Hide Details)

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

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