musicwithmindy.com - Parent/Child Class Enrollment
musicwithmindy.com - Music for Living...Music for Life

               Music Together®
       Parent/Child Class Enrollment Form
   ** please complete all areas and mail form, payment and any
  coupon to: Mindy Arndt, Music With Mindy Learning Studio,                 125-5  N. Main St, Mooresville, NC 28115


Today's Date_________________________________________

Child's Name_______________________________Age:____________

Who will be bringing your child?**_________________________

Parent Name(s)_______________________________________

Mailing Address_______________________________________

City________________________State_____Zip code_________

Daytime Phone(s)________________________Text ok?_______

E-Mail_______________________________________________

Siblings (if attending)___________________________________

Additional Information concerning your child's health, behavior or development, including allergies:__________________________

____________________________________________________

**if different than parent


Semester:_______Fall________Winter________Spring 

Class Preference:___________________1st choice

                            ___________________2nd choice

Tuition Due: 1st Child************$185
                         Siblings: free
Discount, if any__________________

Total Payment Enclosed*********$__________Payable to :Mindy Arndt