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 (Leave blank if NONE)

Food Allergies*

Musical Theatre T Shirt Size

Musical Theatre Pant Size

Musical T Chest Measurement

Musical T Waist Measurement

Musical T Lgth (waist 2 floor)

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 (Leave blank if NONE)

Food Allergies*

Musical Theatre T Shirt Size

Musical Theatre Pant Size

Musical T Chest Measurement

Musical T Waist Measurement

Musical T Lgth (waist 2 floor)

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 (Leave blank if NONE)

Food Allergies*

Musical Theatre T Shirt Size

Musical Theatre Pant Size

Musical T Chest Measurement

Musical T Waist Measurement

Musical T Lgth (waist 2 floor)

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 (Leave blank if NONE)

Food Allergies*

Musical Theatre T Shirt Size

Musical Theatre Pant Size

Musical T Chest Measurement

Musical T Waist Measurement

Musical T Lgth (waist 2 floor)

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 (Leave blank if NONE)

Food Allergies*

Musical Theatre T Shirt Size

Musical Theatre Pant Size

Musical T Chest Measurement

Musical T Waist Measurement

Musical T Lgth (waist 2 floor)

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.

I've read the above and agree.

Registration Fee

At the time of my initial registration a one time registration fee, presuming continuous enrollment (summer excluded), will be charged to my account. If I withdraw and re-enroll, I understand that an additional registration fee will be required.

I've read the above and agree.

Enrollment & Tuition Fees

Enrollment is ongoing until such time as I choose to un-enroll (summer excluded). Fees are based on an annual school-year enrollment. Total Fees are divided into equal monthly payments - 9 months for the full school year enrollment, September thru May. Enrollment may occur at any time; The first month's fees are prorated to reflect the student start date.

I've read the above and agree.

Withdrawing From Class

In the event I wish to withdraw from class, I must email Music Connections with my intent to do so. This email must be received before the last day of the month of my current class to avoid charges for the following month.

I've read the above and agree.

Photo Permission

Music Connections has my permission to use photographs or video of my child from class for occasional promotional postings (no last names used). If I disagree and do not wish my child to be photographed, I must email the studio administrator. I understand that when parents are photographing / video recording their own child in class it is possible that my child may be included in those photos, for which Music Connections cannot be held responsible.

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