Registration

Parents, it's time for a well deserved night out this school year and Kids' Orchestra has you covered! We will be hosting a Date Night Datecare event at our new office (647 Main Street) from 6-9pm where you can leave your little ones in safe hands without the large price of a babysitter. We will be providing dinner, music inspired arts & crafts, and a movie with popcorn!

Discounts available for multiple children: $25 for 1 child, $35 for 2 children, $15 per child for 3 or more.

Discounts will be applied manually before payment is charged.

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: *

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

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Child's Ethnicity:*
	Previous musical experience?:*
	Attending aftercare at school?:*
	Dietary restrictions?:

Additional Information:

Payment for event

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