Register for a Class

Flutes MomI'm glad you have decided to join us in making music. Please remember, if there is only one class that you are interested in, register as soon as possible.

$190 (first child)

Additional sibling is $120.00.

You must register before January 3, 2012 to avoid an additional $5 late fee.

Please complete the form below to begin the registration process. If there is space in your requested class(es), I will then send you an e-mail invoice so you may pay securely online. You will not be fully registered without payment.

By registering, you affirm that you have read and agree to my Policies.

Parents' Names: 
Contact E-mail:   
Street Address:   
City, State, Zip:   
Phone (h):              
Phone (w):             
E-mail:                     
Occupation(s):      
What instruments 
(if any) do you play?
Child's Name (1):      
Child's Birthday (1):
Child's Name (2):      
Child's Birthday (2):
Child's Name (3):      
Child's Birthday (3):
Referred by (name and phone or e-mail):
Please send me memos via:   E-mail   Postal Mail

Winter 2011 Session:
Location Day/Time:
(1st preference)

Location Day/Time:
(2nd preference)
Please send me an e-mail invoice for:

Click to view and print coupon(s). Please bring to first class.

  1. Early full payment discount of $10.00, if paid in full by December 26. After that date it expires.

I would like to ask all of you who do not need to pay by credit card to please pay by check. If enough of you do so I will be able to continue to offer discounts. Minimum of $50 to pay by credit card. All credit card payments must be in full, or, if you pay the $50 deposit, the balance must be paid by check at the first class. If you pay by credit card and I must cancel the class time slot (because of low enrollment or any other reason) you will only be reimbursed your payment minus the credit card processing fee. See Schedule & Fees page for full fee information.

After submitting this form, if there is space in your requested class(es), you will receive an e-mail invoice from me within a day or two, with instructions on how to pay securely by credit card online. Submitting this form does not guarantee you a place in class; payment of the invoice will.


If you prefer, you may click this link to view and print a registration form, then complete it and mail with your check to:

Juliana's Music Together
101 Dogwood Lane
Newburgh, NY 12550

Please make checks payable to Juliana's Music Together. If you pay by check, I will confirm your registration by phone. Again, registration will not be complete without payment.

  

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