February 22, 2012
February 22, 2012
Registration Form For
MTLC Explorers   ::   MTLC Family  ::   MTLC Explorers
 
 
 
Child's First Name*
Child's Last Name*
Birthdate*
Parent/Guardian*
Address*
City*
State*
Zip Code*
Home Phone*
Cell Phone*
Email*
Choose Class*
Policy Agreement*
I understand a minimum, non-refundable $50 deposit is due with this form to hold my spot in class.  A minimum of 5 children are needed to hold a class. If my class is in jeopardy of being cancelled due to low enrollment, I will have the option to choose another class or be granted a full refund.  There are no refunds for absences.  I will be notified if there is another Music Time class I can attend as a make-up.
Agree   
 
 
Media Release*
I grant permission fro my child and myself to be photographed or videoed by a representative of  Music Time Learning Center from any responsibility or liability for any claims arising from the publication or reproduction of any photographs, interviews or videos in any news, website, or other media.  Media may be used for promotional purposes and grant justification          
Yes   No   
 
Right after you click on Submit button and see "Submission has been sent!", please press back button to return to this page and process your payment.
 
 Payment Information
Registration is not complete until your $50 deposit or payment in full is received.
After submitting your registration return to this page.  For PayPal:
OR
Mail a check to: 
Music Time Learning Center
1747 Tidewell Trace
Lawrenceville, GA 30043
  

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