Music Together^® By the Dunes

Registration

(You may "drop in" for a fee of $25 for a maximum of two visits – please call ahead to reserve a spot.

All drop in students will be accommodated after registered students.)

For Credit Card payments and registration, click the following link: CREDIT REGISTRATION

For payment via MAIL, print and mail the following to the address at the bottom. Make sure to include FULL payment.

Name (Parent's):________________________  Caregiver_____________________

Address: ____________________________________________________________

City: ___________________________  State: ____  Zip Code: ________________

Home Phone: (____)_________________  Work Phone: (____)________________

E-mail: ______________________________________________________________

Child #1: _____________________________  Birthday: _______________________

Child #2: _____________________________  Birthday: _______________________

NEW FAMILIES: How did you hear about us? Thank you!_______________________

_______________________________________________________________________

If you have a different summer and winter address, please give both.

Please list the day and time of the class you would like....	Course fee
First Choice (day/time)	$175
Second Choice (day/time)	---
Sibling Fee (reduced rate for siblings)	$135
Registration Fee (New Families: $15.00 non-refundable)	$15
Total Payment (Registration will be confirmed by mail, email or phone.)	$

Make check payable to Ina Ferrara and mail to :

Music Together by the Dunes · PO Box 1189, Quogue, NY 11959 · TEL: 631-764-4180

Music Together by the Dunes is licensed by Music Together LLC. For more locations: www.musictogether.com - (800) 728-2692