Mason's School of Music Online Registration

Registration

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* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone

Contact #1

Contact #1 First Name*

Last Name *

Relationship to Student*

How Can We Contact You?

Home Phone

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Relationship to Student

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School

Grade Level

Special Needs You Would Like Us To Be Aware Of

Allergies

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School

Grade Level

Special Needs You Would Like Us To Be Aware Of

Allergies

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School

Grade Level

Special Needs You Would Like Us To Be Aware Of

Allergies

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School

Grade Level

Special Needs You Would Like Us To Be Aware Of

Allergies

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School

Grade Level

Special Needs You Would Like Us To Be Aware Of

Allergies

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Payment Procedures (Lessons and Classes)

For Music, Dance, After School or Kindermusik Classes only. At your first lesson please come to the office so that we can complete your registration process. We offer three ways to pay for classes. Pre-authorized credit card charges, pre-authorized bank account drafts or full semester payments. This does not apply to summer camps or recitals, but please check to continue.

I've read the above and agree.

Deposit (Camps Only)

For camps only. At this time you can pay the $40 deposit (per camper, per camp), or the full amount. Please note which you prefer in the comments field below. If a preference is not made, then the deposit will be charged. If you are registering for lessons or classes or recital, this does not apply, but please check to continue.

I've read the above and agree.

Remaining Balance (Camps Only)

For camps only. If you only pay the deposit then the remaining balance will be due the morning of the first day of each camp. The balance will be charged to your credit card or bank account on the first day of camp, unless you pay the balance in person at drop off on the morning of the first day of camp. Sibling and full day option discounts will be applied once we receive your registration. If you are registering for lessons or classes or recital, this does not apply, but please check to continue.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Please fill out ONE of the following Payment Methods

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number