Newark Music Makers,Newark Music Makers Musikgarten: Children's/Kid's Music Classes Serving Newark, Hockessin, Middletown and Wilmington,Delaware

Registration

Please use the following form to register each child for one of our classes.

If you do not want to register on line, download this PDF file RegistrationForm.pdf and bring it to the first class. Please send me an emai or call the number above to alert me of your intent to register. You will need Adobe Acrobat to view this document. Go to www.adobe.com to download free Acrobat Reader.

We will contact you after we receive your registration to confirm the availability and provide additional information on materials you should bring with you to class.

Select Class:

Preferred Day/Time:	(e.g. Tuesdays 09:30)

Parent's First Name:
Parent's Last Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Email Address:
Home Phone Number:	- -
Work Phone Number:	- -
Cell Phone Number:	- -

Alt. Contact Person:
Alt. Contact Phone:	- -

Child's First Name:
Child's Last Name:
Child's Current Age:	months years
Child's Birthdate:	(MM/DD/YYYY)

List any allergies or medical issues of which the teacher should be aware:


How did you hear about us?:

Other:

Question/Comment: