Registration

Mommy & Me Classes (Babies, Toddlers, Preschoolers)
Please read our MOMMY & ME POLICIES carefully before submitting registration. It covers important information about classroom procedures, weather cancelations, payment, and registration. All new families will be asked to sign an INFORMED CONSENT form before class.

Music Makers Afterschool (Grades 1 and 2)
Please read our MUSIC MAKERS AFTERSCHOOL POLICIES (Immanuel grades 1-2) carefully before submitting registration. It covers important information about classroom procedures, weather cancelations, payment, and registration. Print and sign the AFTERSCHOOL INFORMED CONSENT and send it in with payment (checks made out to Immanuel Lutheran Church: Musikgarten) by Friday, Sept. 6.

Select Class:

Preferred Day/Time:	(e.g. Tuesdays 09:30)

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: