Music & Movement Registration Form

Summer 2019

Thank you for registering for an early childhood music and movement Summer Sampler.

If you wish to mail in a check or pay with cash (call ahead before visiting), please complete this form.

  • Please note class name in the memo line of your check.
  • Kindly mail your check within two days of submitting this form.
  • Your registration will be completed and confirmed when payment is received.

Thank you.

Long Form - Summer Sampler Reg Form

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • If you wish to register for 4 weeks (rather than 5), please enter the class date you will not be attending or enter "Saturday."
    Do you give Pakachoag Music School permission for yourself and/or your child(ren) to be photographed and/or videotaped during school functions for school purposes and for such photos or videos to be used commercially by the school, including postings on the School web site.
    Submitting total payment in one check, if registering multiple children, is fine.
  • Please review our Summer Program policies at this link prior to completing registration, and confirm your acceptance below. Summer Registration Policies