Music Together with Ann Quinn - Registration Step 1

Fill in the form and print

Class session 1st Choice 2nd Choice
Day: Time: Day: Time:

Parent Names(s):
Attending caregiver name:
Attending caregiver relation:
Address:

City:

State:

ZipCode:

Parent Home Phone: Work phone:

e-mail address:

Please include name and birthday of all children attending class, including
non-paying siblings.

Child 1:	Sex:	DOB:
Child 2:	Sex:	DOB:
Child 3:	Sex:	DOB:
Class fee for 1st child and parent Class fee for each additional child Siblings under 9 months old		$ 165 $ 100 Free
Tuition is due with application.
No tuition refunds after the second class.
Print this form and return it with a check payable to: Ann Quinn Music Together 110 N Beechwood Ave Catonsville, MD 21228

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