Summer 2018

Summer 2020 Registration

We are very excited to have you joining us for our Online Summer Semester at The Music Factory! When you click [Continue] below, you will automatically be taken to PayPal to submit your registration deposit. THE DEPOSIT IS REQUIRED TO PROCESS YOUR REGISTRATION. You will receive an invoice by email with your balance due, reflecting this deposit, materials, registration fees ($20 for new families, $10 for returning families), referral bonuses, and sibling discounts.
Parent's First & Last Name:*
Address Line 1:*
Address Line 2:
City, State, ZIP:*
Email Address:*
Phone Number:*
Alternate Phone Number:
How many children will you be registering for classes?*

OneTwoThreeFour
Child's First & Last Name:*
Child's Age (Years and Months):
Child's Birth Date:*

MonthDayYear
Select Summer Semester Class:*
List any allergies, special needs, or medical issues of which the teacher should be aware:
Second Child's First & Last Name:
Second Child's Age (Years & Months):
Second Child's Birth Date:

MonthDayYear
Select Summer Semester Class for Second Child:
List any allergies, special needs, or medical issues of which the teacher should be aware:
Third Child's First & Last Name:
Third Child's Age (Years & Months):
Third Child's Birth Date:

MonthDayYear
Select Summer Semester Class for Third Child:
List any allergies, special needs, or medical issues of which the teacher should be aware:
Fourth Child's First & Last Name:
Fourth Child's Age (Years & Months):
Fourth Child's Birth Date:

MonthDayYear
Select Summer Semester Class for Fourth Child:
List any allergies, special needs, or medical issues of which the teacher should be aware:
Instrument for Private Lesson:

PianoVoiceHarpFluteUkuleleSaxophoneOboe
What days and times are you available for lessons?

Monday afternoonMonday eveningTuesday morningTuesday afternoonTuesday eveningWednesday morningWednesday afternoonWednesday eveningThursday morningThursday afternoonThursday eveningFriday morningFriday afternoonSunday evening
Instruments available for purchase (optional, includes sales tax):

One pair rhythm sticks - $2.95One pair shakers - $10.74One scarf - $2.52One pair jingles - $8.21One pair sandblocks - $7.67One pair finger cymbals - $7.55Other
May we have your permission to use pictures of your child on our website or social media (no names are disclosed)?

YesNo
How did you hear about The Music Factory?
I understand I am enrolling my child for a full semester program each time I register him/her, and full payment is required for the semester. I realize that if I do not continue, regardless of the reason, $50 is NON-REFUNDABLE to cover administrative costs. I understand that I will notify the teacher or director if we will miss a class, and that a make-up class is only available in this case. Make-up classes must be scheduled in advance. By submitting this form, I have agreed to the above policies.*

Agree
Pay your registration deposit ($50 per student):

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USDRegistration Deposit
Should be Empty:

Summer 2020 Registration