Registration
Give the Gift of Music - Purchase a Gift Certificate for friends or family. You can choose to have the Gift Certificate emailed or mailed to you or the recipient.
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: *
 
 
 
Questions/Options:
Private Lessons: 30 minute one-on-one lessons once a week on any of our 20 instruments ($42 per lesson). Please specify the number of lessons for the Gift Certificate.
Rhythm, Melody & Harmony for Kindergarten thru 2nd grade. Group classes are once a week for 45 minutes ($99/mo). Please specify number of months for the Gift Certificate.
Music & Me for toddlers and preschool. Group classes are once a week for 45 minutes with two age groups: 18 mos to 2 yrs and 3 to 4 yrs ($99/mo). Please specify number of months for Gift Certificate.
There is an annual $40 registration fee per family. Would you like to include this fee in the Gift Certificate? If no, the fee will be paid by gift recipient.
Gift Giver's Name
Recipient's Name and Age
Message on gift certificate
Please indicate if you would like to pick up the gift certificate or have it emailed or mailed. Please provide email or mailing address if applicable.
 
Additional Information:
 
 
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:*