Registration

Please use the following form to register each child for one of our classes. Send a registration fee of $187 +$33 for materials & classes for (Babies classes)-$265+ $33 for materials & classes for (Toddlers classes)-$216 +$45 for materials & classes for (Cycle of Seasons classes) 3y to 5y.olds. $ 275 + $33 for Mixed Ages. Payment : via check payable to: Musikgarten of Burlington

We will contact you after we receive your registration to confirm the availability and provide additional information on materials you should bring with you to class.

Select Class:

Preferred Day/Time:	(e.g. Tuesdays 09:30)
Preferred Location:

Parent's First Name:
Parent's Last Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Email Address:
Home Phone Number:	- -
Work Phone Number:	- -
Cell Phone Number:	- -

Alt. Contact Person:
Alt. Contact Phone:	- -

Child's First Name:
Child's Last Name:
Child's Current Age:	months years
Child's Birthdate:	(MM/DD/YYYY)

List any allergies or medical issues of which the teacher should be aware:


How did you hear about us?:

Other:

Question/Comment: