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You're registering in a Pop-Up Kindermusik Class for children ages 0-4 years. Get ready to groove, giggle, snuggle, and make special memories with your child in this 45 minute music and movement class. To keep the music going when you head home, your registration will also include access to Kindermusik's online music library for the week. NOTE: Location for our summer pop ups is: LANES RETIREMENT LIVING, 134 Airport Heights Drive Cost: $20 plus tax for first child. Siblings in the same class are 50% off. We can't wait to see you!
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Family Information
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Type
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Doctor/Physician
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Guardian
Mother
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Parent
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Students entered below will be added to your family's account
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Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Questions/Options:
Are there any allergies/special needs that we need to be aware of? (We kindly request no food/snacks in all of our classes, with the exception of infants still bottle/breastfeeding)
May we use you or your child's photo or video footage for promotion of our future Intervals Music Studio events?
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Yes
No
Additional Information:
SUMMER LOCATION
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I understand that the location for Summer Kindermusik is Lanes Retirement Living in Airport Heights and NOT at Intervals Music Studio on Thorburn Road.
I've read the above and agree.
Participants
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I realize that enrolment in this pop up class can only accommodate ONE parent /caregiver PER CHILD and that siblings can only be accommodated if they are registered as a participant in the correct age grouping.
I've read the above and agree.
Cancellation of event
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I realize that Intervals Music Studio occasionally has to cancel or change events due to the unexpected, but that I will be reimbursed if billing has taken place. I realize that I will not be reimbursed if do not attend the event I enrolled in or if I cancel my enrolment within 48 hours of the event.
I've read the above and agree.
Release
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I release any and all rights and claims for damages against "Intervals Music Studio" and it's staff in the unlikely event of injury sustained by myself or my child(ren) during the course of this event.
I've read the above and agree.
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Exp Year:
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2024
2025
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Address Line 1:
Address Line 2:
Country:
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US - UNITED STATES
CA - CANADA
GB - UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
AU - AUSTRALIA
AD - ANDORRA
AE - UNITED ARAB EMIRATES
AF - AFGHANISTAN
AG - ANTIGUA AND BARBUDA
AI - ANGUILLA
AL - ALBANIA
AM - ARMENIA
AO - ANGOLA
AQ - ANTARCTICA
AR - ARGENTINA
AS - AMERICAN SAMOA
AT - AUSTRIA
AW - ARUBA
AX - ALAND ISLANDS
AZ - AZERBAIJAN
BA - BOSNIA AND HERZEGOVINA
BB - BARBADOS
BD - BANGLADESH
BE - BELGIUM
BF - BURKINA FASO
BG - BULGARIA
BH - BAHRAIN
BI - BURUNDI
BJ - BENIN
BL - SAINT BARTHELEMY
BM - BERMUDA
BN - BRUNEI DARUSSALAM
BO - BOLIVIA
BQ - BONAIRE, SINT EUSTATIUS AND SABA
BR - BRAZIL
BS - BAHAMAS
BT - BHUTAN
BV - BOUVET ISLAND
BW - BOTSWANA
BY - BELARUS
BZ - BELIZE
CC - COCOS (KEELING) ISLANDS
CD - CONGO (THE DEMOCRATIC REPUBLIC OF THE)
CF - CENTRAL AFRICAN REPUBLIC
CG - CONGO
CH - SWITZERLAND
CI - COTE D'IVOIRE
CK - COOK ISLANDS
CL - CHILE
CM - CAMEROON
CN - CHINA
CO - COLOMBIA
CR - COSTA RICA
CU - CUBA
CV - CABO VERDE
CW - CURACAO
CX - CHRISTMAS ISLAND
CY - CYPRUS
CZ - CZECH REPUBLIC
DE - GERMANY
DJ - DJIBOUTI
DK - DENMARK
DM - DOMINICA
DO - DOMINICAN REPUBLIC
DZ - ALGERIA
EC - ECUADOR
EE - ESTONIA
EG - EGYPT
EH - WESTERN SAHARA
ER - ERITREA
ES - SPAIN
ET - ETHIOPIA
FI - FINLAND
FJ - FIJI
FK - FALKLAND ISLANDS (MALVINAS)
FM - MICRONESIA, FEDERATED STATES OF
FO - FAROE ISLANDS
FR - FRANCE
GA - GABON
GD - GRENADA
GE - GEORGIA
GF - FRENCH GUIANA
GG - GUERNSEY
GH - GHANA
GI - GIBRALTAR
GL - GREENLAND
GM - GAMBIA
GN - GUINEA
GP - GUADELOUPE
GQ - EQUATORIAL GUINEA
GR - GREECE
GS - SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
GT - GUATEMALA
GU - GUAM
GW - GUINEA-BISSAU
GY - GUYANA
HK - HONG KONG
HM - HEARD ISLAND & MCDONALD ISLANDS
HN - HONDURAS
HR - CROATIA
HT - HAITI
HU - HUNGARY
ID - INDONESIA
IE - IRELAND
IL - ISRAEL
IM - ISLE OF MAN
IN - INDIA
IO - BRITISH INDIAN OCEAN TERRITORY
IQ - IRAQ
IR - IRAN, ISLAMIC REPUBLIC OF
IS - ICELAND
IT - ITALY
JE - JERSEY
JM - JAMAICA
JO - JORDAN
JP - JAPAN
KE - KENYA
KG - KYRGYZSTAN
KH - CAMBODIA
KI - KIRIBATI
KM - COMOROS
KN - SAINT KITTS AND NEVIS
KP - KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
KR - KOREA, REPUBLIC OF
KW - KUWAIT
KY - CAYMAN ISLANDS
KZ - KAZAKHSTAN
LA - LAO PEOPLE'S DEMOCRATIC REPUBLIC
LB - LEBANON
LC - SAINT LUCIA
LI - LIECHTENSTEIN
LK - SRI LANKA
LR - LIBERIA
LS - LESOTHO
LT - LITHUANIA
LU - LUXEMBOURG
LV - LATVIA
LY - LIBYA
MA - MOROCCO
MC - MONACO
MD - MOLDOVA, REPUBLIC OF
ME - MONTENEGRO
MF - SAINT MARTIN
MG - MADAGASCAR
MH - MARSHALL ISLANDS
MK - NORTH MACEDONIA
ML - MALI
MM - MYANMAR
MN - MONGOLIA
MO - MACAO
MP - NORTHERN MARIANA ISLANDS
MQ - MARTINIQUE
MR - MAURITANIA
MS - MONTSERRAT
MT - MALTA
MU - MAURITIUS
MV - MALDIVES
MW - MALAWI
MX - MEXICO
MY - MALAYSIA
MZ - MOZAMBIQUE
NA - NAMIBIA
NC - NEW CALEDONIA
NE - NIGER
NF - NORFOLK ISLAND
NG - NIGERIA
NI - NICARAGUA
NL - NETHERLANDS
NO - NORWAY
NP - NEPAL
NR - NAURU
NU - NIUE
NZ - NEW ZEALAND
OM - OMAN
PA - PANAMA
PE - PERU
PF - FRENCH POLYNESIA
PG - PAPUA NEW GUINEA
PH - PHILIPPINES
PK - PAKISTAN
PL - POLAND
PM - SAINT PIERRE AND MIQUELON
PN - PITCAIRN
PR - PUERTO RICO
PS - STATE OF PALESTINE
PT - PORTUGAL
PW - PALAU
PY - PARAGUAY
QA - QATAR
RE - REUNION
RO - ROMANIA
RS - SERBIA
RU - RUSSIAN FEDERATION
RW - RWANDA
SA - SAUDI ARABIA
SB - SOLOMON ISLANDS
SC - SEYCHELLES
SD - SUDAN
SE - SWEDEN
SG - SINGAPORE
SH - SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA
SI - SLOVENIA
SJ - SVALBARD AND JAN MAYEN ISLANDS
SK - SLOVAKIA (Slovak Republic)
SL - SIERRA LEONE
SM - SAN MARINO
SN - SENEGAL
SO - SOMALIA
SR - SURINAME
SS - SOUTH SUDAN
ST - SAO TOME AND PRINCIPE
SV - EL SALVADOR
SX - SINT MAARTEN
SY - SYRIAN ARAB REPUBLIC
SZ - ESWATINI
TC - TURKS AND CAICOS ISLANDS
TD - CHAD
TF - FRENCH SOUTHERN TERRITORIES
TG - TOGO
TH - THAILAND
TJ - TAJIKISTAN
TK - TOKELAU
TL - TIMOR-LESTE
TM - TURKMENISTAN
TN - TUNISIA
TO - TONGA
TR - TURKEY
TT - TRINIDAD AND TOBAGO
TV - TUVALU
TW - TAIWAN, PROVINCE OF CHINA
TZ - TANZANIA, UNITED REPUBLIC OF
UA - UKRAINE
UG - UGANDA
UM - UNITED STATES MINOR OUTLYING ISLANDS
UY - URUGUAY
UZ - UZBEKISTAN
VA - HOLY SEE
VC - SAINT VINCENT AND THE GRENADINES
VE - VENEZUELA (BOLIVARIAN REPUBLIC OF)
VG - VIRGIN ISLANDS (BRITISH)
VI - VIRGIN ISLANDS (U.S.)
VN - VIET NAM
VU - VANUATU
WF - WALLIS AND FUTUNA ISLANDS
WS - SAMOA
YE - YEMEN
YT - MAYOTTE
ZA - SOUTH AFRICA
ZM - ZAMBIA
ZW - ZIMBABWE
City:
State/Prov:
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Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
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