Music Connections Foundation / Kindermusik Online Registration

Registration

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Welcome to our Music Connections Foundation family! We believe an investment in early music education will benefit your child for LIFE! Please complete the following registration form. We look forward to your family joining our classes and to our journey together!

* 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 *

Type*

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

Type

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

Special Needs

Allergies

MT Camp T Shirt Size*

MT Camp Pant Size*

MT Camp Dress Size

Please click on the Search button below, then choose the class.

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

Special Needs

Allergies

MT Camp T Shirt Size*

MT Camp Pant Size*

MT Camp Dress Size

Please click on the Search button below, then choose the class.

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

Special Needs

Allergies

MT Camp T Shirt Size*

MT Camp Pant Size*

MT Camp Dress Size

Please click on the Search button below, then choose the class.

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

Special Needs

Allergies

MT Camp T Shirt Size*

MT Camp Pant Size*

MT Camp Dress Size

Please click on the Search button below, then choose the class.

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

Special Needs

Allergies

MT Camp T Shirt Size*

MT Camp Pant Size*

MT Camp Dress Size

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Billing Agreement

I understand that it is my responsibility to keep my credit card information up to date. Any delays in current information may result in Music Connections assessing payments beyond nine months or doubled charges in order for my account to remain current.