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**To enroll your child, print out this page, fill in the information, and send it with the fee to the address below.
Once we've received your registration we will send you a confirmation by email.
Child's name_________________________ Age___________Parent's name________________
Address______________________________ Zip___________Phone___________________
Email (to confirm registration)_______________________________________
School Attends______________________ Grade________
Instruments at home_______________________________
How did you hear about us?____________________
COURSE:
____ Toddler Tunes or Toddler Tunes 2 ($125 due)
____ Music in Me ($160 due)
____MORE Music in
Me ($160)
____ Group Piano - Kindergarten ($100 enrollment fee due)
____ Group Piano
- 1st/2nd Grade ($100 enrollment fee due)
____ Group Piano - 3rd-5th Grade ($100
enrollment fee due)
Class Day:____________________ Class Time:______________ Class Begins:_________________
*With the exception of infants who must remain in infant seats, siblings are not allowed in any Harmony Road class.
We're sorry that we cannot accommodate strollers in our classroom.
**Makeup lessons available ONLY if there is another class at same level and if there is room in that class. There are
no refunds or credits.
Mail form and fee to:
Harmony Road Music School
5381 Truxtun Ave.
Bakersfield, CA 93309
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