Registration

Suggested Donation of $5/person: https://musichousechicago.com/checkout/donate?donatePageId=63f54672b5b865013ec35894

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Relationship to Student*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info

Students entered below will be added to your family's account

Add New Student #1:

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Questions/Options:


If your child is performing, what instrument/song/dance will they perform? Please choose 1 song so we can accommodate as many students as possible! (Students who are attending to watch can write N/A.)*

Additional Information: