Register for Preschool Music ClassPlease enable JavaScript in your browser to complete this form.Which class would you like to register for?Wednesdays 9:00-9:45 a.m. (PreK 4s)Your Name *FirstLastEmail *Phone/Text *Preferred Method of Communication *EmailPhoneTextIn the event of an emergency during class, who should I call if you are not available? *FirstLastPhone *Relation *Child's Name *Prefers to be called...Child's Gender *MaleFemaleAge *Birthdate *If your child has food allergies, please list: *Would you like to pay tuition on the 1st or the 15th of each month? *the 1stthe 15thHow did you hear about these classes? *I hereby give permission for images of my child, captured during music class through video, photo and digital camera, to be used solely Mindy Rawlinson Piano School's social media, website, and other promotional material and publications. I understand that my child's name will never be used in conjunction with their image. *YesNoMessageSubmit Registration Information
