Cumberland Valley School of Music Online Registration

Registration

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Welcome to Cumberland Valley School of Music! Please complete the following registration form. SPECIAL NOTE: By entering your payment information below, it DOES NOT charge your card. You will need to log in to the portal and pay the balance.

* 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*

Primary Phone*

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Home Phone

Work #

Cell #

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Cumberland Valley School of Music. Standard message and data rates apply. Reply STOP to opt out

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

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Cumberland Valley School of Music. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Cumberland Valley School of Music. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

Grade Level

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*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Cumberland Valley School of Music. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

Grade Level

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*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Cumberland Valley School of Music. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

Grade Level

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*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Cumberland Valley School of Music. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

Grade Level

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*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Cumberland Valley School of Music. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

Grade Level

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

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

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

Registration

Referral Information

Family Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

(Show-Hide Details)