Willamette River Music Together

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Below is a form you can fill out to register for one of our classes.

Tuition is $170.00 per child. Tuition includes 2 CDs, an illustrated and musically notated songbook, and a parents guide based on the research from the Center for Music and Young Children (CMYC).

- 0ne-time nonrefundable family registration fee of $25.00.

- Siblings of the first registered child receives a reduced rate of $120.00.

- Siblings under 9 months are FREE!

- Each family is allowed one make-up per semester on a space available basis.

We'll confirm your registration once we have received payment.

* Your First Name:
* Your Last Name:
*Mailing Address:
*City:
*State/Province:
*Zip:
*Phone:
Other Phone:	Type (work, cell, etc):
*Email:	Contact Preference:
*New or Returning Family:

Registrants

	First Name	Last Name	Date of Birth (mm/dd/yy)
Child #1
Child #2
Child #3

Class 1^st Choice

Location:	Class Type:

*Class:
<Select Location and Class Type first>

Class 2^nd Choice — Please select a second class in case your first choice is unavailable.

Location:	Class Type:

Class:
<Select Location and Class Type first>

Waitlist OK?
YesNo

Comments:

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Please note:

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Class 1st Choice

Class 2nd Choice — Please select a second class in case your first choice is unavailable.

Class 1^st Choice

Class 2^nd Choice — Please select a second class in case your first choice is unavailable.