Music Makers Registration 
Ages 1-4, Fridays 9:20-10:00
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What session are you registering your child for? *
Required
Child's Name *
Child's Birthday *
MM
/
DD
/
YYYY
Home Address *
Parent 1 Name *
Parent 1 Cell *
Parent 2 Name *
Parent 2 Cell *
Best person to receive text messages & phone calls *
Best e-mail for school communication *
Emergency Contact name (other than parents) *
Emergency contact relationship to child *
Emergency contact phone number *
Others authorized to drive my child home
Allergies or Medical Conditions. Write "No" if this doesn't apply to your child.  *
Teacher/ Buddy Request - We cannot guarantee all requests will be made, but if we can make it work, we will!
Is it okay for Sprouts Academy to use your child's photograph for promotional purposes online and/or in printed format? *
Would you like your contact information to be accessible to other parents from Sprouts Academy for birthday invitations or scheduling playdates? *
I have reviewed the Policies and Procedures contract provided on the Parent Resources page of the school website and agree to accept and follow them. *
By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge: *
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