Music & Movement Center at MYAC Registration

Child’s Information

Child’s First Name:
Child’s Last Name:
Home Phone:
Preferred E-mail:
Address:
City, State ZIP:,
Child’s Birthday (mm/dd/yy):(e.g. 10/15/12)
Parent 1 Name:
Parent 1 Employer:
Parent 1 Cell Phone:
Parent 2 Name:
Parent 2 Employer:
Parent 2 Cell Phone:

Session, Day, and Class Selection

Note: you can only register for one class at a time. If you need to register for multiple children, please fill out the form for each child.

All classes are open to a maximum of 10 children.

You must choose a session AND a class time/day. If the class you want is full, it will not show on the list. Email margueriteoines@mya.org to be put on the waitlist. We will let you know if your registration is confirmed.

Please Note: Classes for 3 years and older are without parent

Session:
Monday Classes:
Tuesday Classes:
Wednesday Classes:

Submit Your Form

Registration for Session IV is now closed. To be notified when registration for 2017-18 opens, please email margueriteoines@mya.org!

Payment Information

Registration is open until the second class of each session. You may make a secure, on-line payment in the amount of $120 as soon as you register for the class, or you may bring in a check on the first class (preferred). Payment must be made in full by the 2nd class session or else a $10 late fee will be assessed.

Please note: Financial assistance is available.