MTLC Class Registration -- Music Time Learning Center

, Guest!

Friday, September 3, 2010

A Non-Profit Organization

Registration
Summer Schedule

Home
Our Programs
About Us
Calendar
Our Photos
Donate!
Employment
Contact Us

Our Mailing Address:
1747 Tidewell Trace
Lawrenceville, GA 30043

Our Phone: 404.353.8621

Our E-Mail: info(at)musictimelearning(dot)org

To subscribe to our enewsletter, please enter your email address in the box below and click the "Subscribe" button.

Note: You may easily remove yourself from the newsletter list at any time by following the instructions included with every mailing.

MTLC Class Registration

Please complete the form below and submit it along with your payment. You will receive a confirmation email from us stating that your registration has been received.

NOTE: Required fields are noted with an *.

Class You Are Registering For:

* (Click here to view class list)

Child:

First Name *

Last Name *

Age *

Date of Birth (mm/dd/yyyy) *

Grade *

Parent/Guardian:

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Cell Phone

Home Phone *

E-mail *

Media release with child's name and parent/guardian "signature":

It is my understanding that these photos may be used for public viewing on MTLC's promotional materials such as websites, brochures, posters and annual reports. I agree to release these pictures without financial remuneration and I understand that this releases Music Time Learning Center and its instructors from any future claims and liability arising from the use of said photograph(s).

I give permission to Music Time Learning Center, Inc. to photograph my child

I do not give permission to Music Time Learning Center, Inc. to photograph my child