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Songbirds Mission Valley Registration
Please provide the information below so that we can provide the best group possible for your child.
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Child's Name
*
Your answer
Parent/Contact Name
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Special Need/Disability (music experiences will be adapted to meet these needs)
*
Your answer
Dates, Location & Times
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MV= Mission Valley (11:30 time slot no longer available)
June: 7th, 14th, 21st, 28th TIME: 1:15pm-2:00pm
July: 5th, 12th, 19th, 26th TIME: 1:15pm-2:00pm
Required
Payment Options (please choose at least one)
*
Please note: Pre-registration is non-refundable meaning there is no refund for missed sessions. Payment must be received at least 24 hours before the first day of class to qualify for pre-registration.
Pre-registration for all 4 classes $70
Drop-in rate $20/per class (cash or check only)
Sibling rate for all 4 classes $60 ($10 discount) with 1 prepaid registration for all 4 classes
If you are pre-registering, how will you be paying?
*
Please skip this question if you are doing the drop-in rate.
Check (made out to MTCCA)
Cash
Credit card
Required
How did you hear about Songbirds?
*
(please check one)
Presentation
Flyer/magazine
School
Friend
Website
Professional
Other:
Have you ever registered for Songbirds in the past?
*
Yes
No. If no, then please fill out the questions below so we can meet the needs of your child.
Required
What rewards are motivating to your child? What prompts work best?
Your answer
What favorite songs, artists, or music games/videos does your child enjoy?
Your answer
Has your child ever had music lessons or been in music therapy before? If so, where and for how long?
Your answer
Does your child have any behavior issues we should be aware of? If so, what approaches have been most successful?
Your answer
Has your child ever been in a social or music group before? If so, please share what program.
Your answer
Does your child need special assistance with communication? If so, please explain.
Your answer
To help your child be successful, is there anything else you would like us to know?
Your answer
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