Registration Form:

Parent's Name: ________________________________________

Address: _____________________________________________

Home Phone: _________________ Business: _________________

Cell: ________________________________________________

Child's Name:_________________________________________

Age: _______________________________________________

1) Emergency Contact Person: ____________________________

    Phone: ___________________________________________

2) Emergency Contact Person: ____________________________

   Phone: ____________________________________________

Does your child have any health problems? Please list, including any allergies we should know about:




Please enclose cash or cheque made out to Let's Make Music for $125

The undersigned agrees that Let's Make Music and its proprietors will not be responsible for any accident or loss however caused and agrees to release Let's Make Msic and associated proprietors from all claims or damages which may arise as a result of or by any such accident or loss.

____________________________________    _____________
Parent or Guardian's signature                          Date