Musikgarten Musikgarten

JEFFERSON CITY MUSIC ACADEMY / HAYNES MUSIC STUDIO
Located at 1411 Southwest Blvd., Jefferson City, MO

Contact: 573-634-5872    helen@jeffersoncitymusicacademy.com

 

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Registration

Registration now open.  Register early to secure your space. 
Please use the following form to register each child for one of our classes. Please plan on filling out your payment form before your first class - either by stopping in before that day, or by coming early for your first class.

If you do not want to register on line, download this file RegistrationForm.rtf and send to:
Helen Haynes
106 Chico Dr.
Ashland, MO   65010

I will contact you after I receive your registration to confirm the availability.


 


Select Class:  

Preferred Day/Time:  (e.g. Tuesdays 09:30)
Preferred Location:  
 
Parent's First Name:  
Parent's Last Name:  
Address Line 1:  
Address Line 2:  
City:  
State/Province:          
Zip/Postal Code:  
Email Address:  
Home Phone Number:   -   -  
Work Phone Number:   -   -  
Cell Phone Number:   -   -  
Alt. Contact Person:  
Alt. Contact Phone:   -   -  
Child's First Name:  
Child's Last Name:  
Child's Current Age:   months     years
Child's Birthdate:   (MM/DD/YYYY)  
List any allergies or medical issues of which the teacher should be aware:  
How did you hear about us?:  
Other:  
Question/Comment: