Music and Me Registration 2025-26

Music and Me Registration

For children ages birth to 5 with visual impairment or combined hearing and vision loss (deaf-blind). Every 3rd Thursday of the month from 11:15-11:45 AM CST.
Parent/Caregiver Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Child Attending the Music Sessions

First NameLast Name
Child's Age
Does your child have any of the following?

Other
During the live sessions, participants will not have their camera on since it will be recorded. Do you wish to have your child's first name used in songs?
Do you need any accomodations?

Other
Request for accommodations must be provided a week before the event to give us time to locate interpreters or prepare other accommodation requests. Thank you.

Questions? Please email: kkirchhoff@kssdb.org
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