Preschool Play Music
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Student's Name *
Student's Age *
Student's birth month
Parent or Guardian's Name *
Home Phone
Cell Phone
Work Phone
Address
The regular class day/time is Tuesdays at 3:30. However for the trial period an extra class will be added.
For planning purposes for extra class times, please indicate whether you are available on the following days and times. You may make further comments in a comment box below.
If you have any comments regarding scheduling, please add here, or text me @ 581-0052
Payment *
Payment must be received for your child to be officially registered for the class. If payment is not received within 2 days your student may be bumped onto the waiting list and their spot given to another. Please indicate by which method you intend to pay below.  
Required
Policies *
Please check to indicate you have read Policies on the Preschool Play Page and agree to abide by them read on right side of this page --->
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Questions, Comments? Write below, or text me @ 581-0052
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