Learning Through Music Registration Form

Learning Through Music: Pre-K and Kindergarten

Registration Form
Summer 2022 Session

July 12 - August 30th

Tuesdays 8:30 - 9:15

This inclusive group is fully online via Zoom.

The cost is $200 per 8 class series (sibling rate $100).

Class rate includes tuition; CD/download of music; a book, scarf, and instrument; activity ideas to use with your child at home; and access to our Empowering Wellness Initiative while enrolled in classes.

Learn more at: https://www.livingspirittherapy.com/groups/learning-through-music/
Child Information
Note: If multiple children are enrolling in classes please fill out child information
separately for both children. Individuals with disabilities are welcome!
Child Name #1

First Name Last Name
Age
Birthdate

Month Day Year
Date
Gender

Male Female
Any relevant diagnosis, personality, or developmental information and/or special needs/
Child Name #2

First Name Last Name
Age
Birthdate

Month Day Year
Date
Gender

Male Female
Any relevant diagnosis, personality, or developmental information and/or special needs/
Parent Information
Name

First Name Last Name
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Caregiver Information

(If someone other than a parent will be bringing child to classes)
Name

First Name Last Name
Relationship to Child
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Class Locations and Schedule

All classes will be held virtually
How do virtual sessions work?
- Virtual sessions require a smart tv, iPad, computer, or another devise that can connect to a browser on the internet.
- We use a HIPPA compliant version of Zoom.
- Upon payment of the registration fee you will receive a link to enter into your browser to connect to classes.
Rates and Discounts
$200 per 8 class series

Current discounts and promotions:
- Registration fees are being waived during the COVID-19 pandemic.
- The sibling rate for additional children if two or more children are registered for classes the same semester is $100.
Payment

Payment is due by the first day of class.
Class Cost(s) Total
Total Due
Payment by check preferred. Write checks out to "Living Spirit Therapy Services" and mail to 2518 Longview Dr.; New Brighton, MN 55112
Payment Method

Credit Card Check

My Products

8 week Learning Through Music Session $ 200.00

8 week Learning Through Music Session.

Total $ 0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please contact Melissa Spiess at melissa@livingspirittherapy.com for the address to mail checks. Payment by check is preferred.
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Learning Through Music: Pre-K and Kindergarten

Child Information

Parent Information

Caregiver Information

Class Locations and Schedule

Rates and Discounts

Payment