Winter 2010 | Studio3Music - The #1 Kindermusik Studio

Please use this SECURE form to make a payment to Studio3Music. Your card will NOT be charged directly from this page. Payment plans, discounts and pro-rated fees will be applied when your card is charged. Thanks!

Winter 2010 Registration

Parent Information
Name*
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Email*
Home Phone*
Work/Cell Phone
Address*
Street AddressAddress Line 2CityStateZip Code
How did you hear about us?
Musical Training
Child Information
Name*
FirstLast
Age*
Date of Birth*
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YYYY
Please type MONTH, DATE and then YEAR. We send birthday cards, and don't want to send it on the wrong date!
Medical Concerns/Allergies
First Names/Ages of Siblings
Musical Training
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Class Location*
Class - Sherman Oaks
Class - Beverly Hills
Class - Bellevue
Class - Bothell
Class - Edmonds
Class - Kirkland
Class - Monroe
Day - Redmond
Class Redmond Monday
Class Redmond Tuesday
Class Redmond Wednesday
Class Redmond Thursday
Class Redmond Friday
Class Redmond Saturday
Class Renton
Day Seattle Symphony
Class Sunday Seattle Symphony
Class Monday Seattle Symphony
Class Friday Seattle Symphony
Class Saturday Seattle Symphony
Class Snoqualmie
Day Woodinville
Class Monday Woodinville
Class Thursday Woodinville
Do you have materials for this class? (we will deduct $20)
Are you enrolling a sibling in any other Studio3Music class? (We will deduct $20 for each additional child)
Would you like to contribute $5 to our scholarship fund?
What is your preferred payment option?
Would you like us to use the card you currently have on file?
Debit/Credit Card Details
We accept Visa, Mastercard and Discover
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Billing Address if Different From Above
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NOTE: $75 of the total fees are due with this registration and are NON-REFUNDABLE. By submitting this Registration, I hereby authorize Studio3Music to apply the total semester fees (less any discounts) to my credit card per the payment plan chosen, if I am paying by credit card. With this enrollment, I am committing to pay for the entire semester per the payment plan chosen. By submitting this registration, I waive and release Studio3Music, LLC and its affiliates, officers, members, employees, attorneys, representatives, successors and assigns (collectively, the "Releasees"), of and from, and promise never to institute, assert, prosecute or pursue, any and all claims, charges, liabilities, claims for relief, demands, suits, action or causes of action against the Releasees, whether based in contract or relating to personal injury or damage to property, arising during the course or as a result of this musical activity. Photo Release: I hereby give Studio3Music, LLC the right to use photographs or video taken at Studio3Music classes or events for publishing, illustration, advertising, trade and promotion, or any other use in any medium for any purpose of Studio3Music. I release Studio3Music from any claims and demands arising out of the use of the photographs or video.
Additional Comments

Winter 2010 Registration

Parent Information

Child Information

Other

Debit/Credit Card Details