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Musical Classes for Children & Grown-Ups
Mother First Name: * Mother's Last Name: *
Mother's Last Name: * Father First and Last Name *
Address: * Apt. #:
City: *
State: *
Zip: *
Phone Number that is best to reach you (Separate with hypens 000-000-0000)
Work Phone: Cell Phone/Pager:
Cell Phone/Pager: (Required) Did you participate in the FALL Session of Music Together with us?
E-mail: *
We will be sending our class confirmations by e-mail. Please make sure that mail from Songs and Signs or Denise Schmitz is on your email "safe list" and delivered to your inbox. If this poses a problem for you, please let us know in the "Other Pertinent Information" box below.
Please list any infant siblings who are under 9 mo who will be attending for free with an older sibling!
Child(ren)'s Names: Child 1 *
Child 2 Child 3 Date(s) of Birth: Child 1 *
Child 2 Siblings under 9 mo=free with registered sibling. Child 3 Please list any infant siblings birthdates, too! See the class offerings below and complete the rest of the form.
8 Week Music Together Winter 2012 Schedule
January 14-March 3, 2012
Crossroads Fellowship Reformed Church, 1200 60th St, West Des Moines, IA 50266
Monday 9:30 AM Ingrid Anthan
Monday 9:30 AM Ingrid Anthan
Tuesday 9:30 AM & 5:45 PM all with Ingrid Anthan
Wednesdays 9:30 AM Maggie Kolbe
Friday 9:30 AM Maggie Kolbe
Saturday at 9:30 AM Maggie Kolbe
1st Choice:
Location:
Day of Week:
Start-Time:
(Required) Have you ever participated in our local Music Together program?
2nd Choice: (This is important for us to know in case your first choice class is full)
Location:
Day of Week:
Start-Time:
3rd Choice:
Location:
Day of Week:
Start-Time:
Other Pertinent information (ie: Are you registering with others, and if so, whom? Are there any special health issues or handicap accessibility and/or accomodations about which we should be informed?
If you are new to Songs and Signs and one of your friends referred you, please put their name here:
Cost:
$140.00 for 1 child if paying via check or cash. $146.00 if paying via credit card.
$240.00 for 2nd sibling (over 9 mos), if paying via check or cash. $250.00 for two children, if paying via credit card
* Method of Payment (You Must Select One):
*Please tell us how you heard about us. (Select One)
Please read the following and indicate your agreement by checking the "Yes" box:
I agree to assume responsibility for my child or children and myself and/or caregiver when upon the premises of a church or other location for a class with Songs and Signs, LLC., and will hold harmless Songs and Signs, LLC and any of its employees and/or agents in the event of any personal injury, property damage or loss, indemnifying said parties of any loss that I might incur as a result.
* I have read and understand the above policy:
A $15 cancellation fee will apply if you cancel after January 12, 2012. No refunds after the first day of classes. Credit for a future session may be given, at the discretion of the Program Director.
If you are registering now and wish to pay with a check, click
If you are registering now and wish to pay online now, click
If you with to erase your registration, click
If you wish to print a registration form and mail it with payment, click below:
To Register for Music Together classes, complete the online form below.
Important Details:
1. Payment via check or cash is preferred. Full payment is due within 5 days your registration in order to secure your child's place in class.
2. We will make every effort to accomodate you, but unless you are re-registering for your same class during priority registration, your preferred class placement is not guaranteed. We will contact you if we cannot place you in any of your choices.
3. Please note that even if a class is not indicated as being full on our website at the time of your submitting this form, there may not be room in it by the time your registration is sent in. This is why it is important to include 2nd and 3rd choices when registering.
4. If you wish to enroll in more than one class, please fill out a separate form. If you are paying online, you will be required to pay for each class independently. (Note: you may register more than one child at a time as long as they are being registered for the same class.)
5. We invite you to call if you have any questions about our classes prior to submitting this form. The best time to call is between 1-5 pm. (515) 457-8834.
* = Required Field
If you have trouble reading the below online form on your computer, just email me your name, phone number, and 1st/2nd choice class (with location, day and time) and either mail a check or click a button below to pay now.
