Enrollment form

 

Please mail to: Music Together Tri-Valley, 3514 saddlebrook place, Dublin CA 94568

You will receive email confirmation.

 

 

Parent’s first and last name……………………………………………………………….............................

 

Child’s name…………………………………(different last name?)……………………date of birth...................................

 

Sibling name…………………………Check if sib is “free” (under 8 mos on 1st day of session)…date of birth.......................

 

Please state DAY, TIME and LOCATION of your chosen class:

 

1st choice……………………………………………………………………………….....     

 

2nd choice …………………………………………………………………………………

Your mailing address:..........................................................................................................................................

Your email.........................................................................................................................................................

Your phone number................................................................................................................................................

 

 

You may enclose a check payable to Music Together OR If you have paid by credit card before we have the number on file, If not please fill in number and exp date:

............................................................................................................ Exp date.............................................

 

Amount we should charge to your card $………………………………….

 

I agree to waive Music Together in the Tri-Valley, Inc., and its staff and teachers, Music Together LLC, Triple Threat Performing Arts, Livermore Valley tennis club, Tao Sports, Contra Costa Ballet Centre, The  Giggle store & Corporation,  Ingram and Braun Musik shoppe, and their owners of all claim for personal injury or property damage that may arise from use of the facilities before, during, or after Music Together classes. I also accept responsibility for my safety and the safety of my children at the studio before, during, and after Music Together classes.

 

Signature (required):………………………………………………………

 

Thank you.  

Music Together Tri-Valley Inc. (925) 551-7722 www.musictogether.net