Music Together of Greater Brevard      

Registration Form Winter 2009

 

Parents/ Caregivers Name(s)_______________________________________________________

Address_______________________________________________________________________

City_______________________________________ State___________ Zip ________________

Home Phone (        ) _____________________Work phone (         )________________________

E-mail ________________________________Cell phone (        ) ________________________

Best mode of contact:  Email ______  Letter ______

How did you first hear about Music Together?  Online (please specify site) ______________________
Word of Mouth _______ Phone Book _______ Space Coast Parent/Brevard County Moms ________
Other (please specify) __________

Child #1 ___________________________________ Birthday____________________________

Child #2 ___________________________________ Birthday____________________________

Child #3 ___________________________________ Birthday____________________________
 

10 week semester including materials: CD, songbook, and a parent guide ( guide for new families only.)

$ 142

Sibling Fee* (Reduced rate for siblings of the first registered child) ____   x   $ 90 per child  =

$

Non- Refundable Registration Fee  (New Families: $15.00 / Returning Families : $5.00)

$

Total Payment Due 

$
Balance Due  (Total Payment Due minus amount enclosed.  Should be zero unless we have a different arrangement.)  
*Infants under 7 months are free with a registered sibling.
 Desired Class Time:
 1st Choice                                          2nd Choice                                         3rd Choice
 

Make checks payable to Debra M. Hart.        Payment may be made in person or mailed to 2416 Forest Park Dr., Melbourne FL 32935.  Tuition is non-refundable after the start of classes.  Refunds provided and cancellations accepted up to one week prior to the beginning of classes.  A fee of $10 will be charged for all cancellations and returned checks. The registration fee is non-refundable. Space reserved when tuition is paid in full.  Materials will be distributed at the first class.  If you have any questions or concerns, please contact Debra Hart at 321-543-0187. Thank you for your participation in Music Togetherâ.