Registration
Kathy's Music Gift Card - purchased in $50 increments. This gift card can be used toward Kindermusik, Group, or Private Lessons only. It does not hold any cash value. Cardholder has 5 years from date of purchase to use this card. Must present card to our office in order to apply amount to your account. NOTE: Please put YOUR name and address at the top of the form under "Family Information."
Event:
Start Date/Time: End Date/Time:
Fee per Family: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info
 
 
 
Questions/Options:
Please Confirm: What is YOUR name?
Please Confirm: What is YOUR mailing address?
Do you want this gift card mailed to another address?*
If yes, provide name and address of the person to receive the gift card.*
What is your cell phone number in case we have questions about your order?*
What is your email address?*
Do you want to purchase more than $50 in Gift Cards? If yes, indicate amount in "Additional Information" section (ie $100, $200, etc). NOTE: Gift cards can only be purchased in $50 increments.
 
Additional Information:
 
Terms of use.
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I've read the above and agree.
 
Value.
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I've read the above and agree.
 
Terms of use continued.
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I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*