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Mommy and Me music class for kids ages 0-5
9-10am on dates listed at 1102 Brookfield Rd
  • Suggested payment is $5 per class. Please Venmo @MUSICTHERAPY901 or request an alternate payment method at the end of this form.
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Mom's name: *
Child's name: *
Child's age: *
Is there any other information about your family that you would like us to be aware of?
Email: *
Which date(s) will you be attending? *
Required
Do you need an alternate method of payment (aka not Venmo)? *
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