Student's Name:

Age (as of September 15, 2004):   Adult Infant 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Birth Date:

Parents or Guardians Names:

Siblings Names: Age:   Adult Infant 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Age:   Adult Infant 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Any Special Needs?

Home Phone: Work Phone:

Email Address:

Address:

City: State: WA OR Zip:

How did you find out about us?

-------------------------------------- Class Selection -----------------------------------------

Kindermusik: Village Our Time Imagine That Young Child

Piano Keyboard: Childrens 6-7Please select a level:
Childrens 8-12 Beginning Level 1A Level 1B Level 2A
Ages 13 - Adult
Private Keyboard Lessons

Voice: Elementary Children's Choir (1st - 5th Grade)
Intermediate Children's Choir (6th - 8th Grade)
Supplemental Private Voice Lessons Select: Bi-Monthly Monthly
Private Voice Lessons

Musical Theater: 5 - 8 years       7 - 10 years

------------------------------------- Day/Time Selection -------------------------------------

If you selected a Kindermusik or a Children's Piano Keyboard class, please check the schedule of classes and select two day/time combinations that will work for you.

1st Choice Day: Time:

2nd Choice Day: Time:

------------------------------------- Payment Options ----------------------------------------

Materials and first month's tuition must be paid at registration. When your registration is received you will be contacted for payment arrangements using one of the following methods:

Payment in Full by Check, Debit, or Credit Card.

Monthly Payments by Check, Debit, or Credit Card.

I agree to abide by the policies of Musical Beginnings. I am enrolling myself or my child in Kindermusik, Keyboard, or Children's Choir for the entire 16 week semester. I understand that any materials fee is non-refundable unless Musical Beginnings is notified more than 2 weeks before the beginning of the semester. Class withdrawal requests received within 2 weeks before class starts or during the first 5 weeks of class are subject to a $30 withdrawal fee minus any classes already attended. There are no refunds after the first 5 week.s Credit toward a future semester may be granted in some circumstances after 5 weeks.