Juliana's Music Together

Registration


 Print and mail or deliver to:
Juliana's Music Together
101 Dogwood Lane
Newburgh, NY 12550
Parents' Names:
Address:
City: State: Zip:
E-mail:
Phone (h): Phone (w):
 
Child's Name (1): Child's Birthday (1):
Child's Name (2): Child's Birthday (2):
Location/Day/Time: Second Choice Day/Time:

Payment
Course Fee Child 1: 
Course Fee Child 2:
 
Current students paying deposit or full payment after registration deadline add $5.00 late registration fee.
 
Total Payment: 
 
Please make checks payable to: "Juliana's Music Together."
Mail all registrations to address at top of page.