Blooming Rhythms Registration Form

Rhythm Garden Music LLC

Blooming Rhythms Early Childhood Arts Program Registration Form
Parent/Caregiver Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Cell

Area CodePhone Number
E-mail
Emergency Contact Person
Phone Number

Area CodePhone Number
Child Name
Birth Date

MonthDayYear
Class Preference
Please indicate the class package you would like to purchase
Please indicate # of punch cards. (One semester will typically use 3 punch cards)
For special occasions, Rhythm Garden Music Studio may provide treats for the students. Please let us know any food allergies your child may have so that we can make appropriate accommodations.
I give Rhythm Garden Music Studio permission to use class photos of my child on website and/or print advertising materials
In the event that a class is cancelled due to weather, illness, emergency, etc., I may be contacted via the following:
How did you hear about us?

Other
Referred By (if 'word of mouth'):
Questions? Comments?
We accept cash or credit/debit.
Make Online Payment

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By submitting your registration, you also agree to receive Rhythm Garden Music Studio's e-newsletter to stay up-to-date on current studio news and enrollment information (We promise not to email frequently). If you would rather not receive the newsletter, you may opt-out at any time.

Please make sure to add msparks@rhythmsgardenmusic.com to your address book to keep studio emails from going to your spam folder.
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Rhythm Garden Music LLC

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