The Music Garden, Houston TX
since 1984

713-270-0480
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Registration


Select Class:  
Preferred Day/Time:    (Please consult schedule for choices)
Preferred Location:  
Parent's First Name:  
Parent's Last Name:  
Address Line 1:  
Address Line 2:  
City:  
State:           Zip Code:  
Email Address:  
Home Phone Number:   -   -  
Work Phone Number:   -   -  
Cell Phone Number:   -   -  
Alternate 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:
Please provide the name of school your child attends and their grade in the field below:
Question/Comment:  
 
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