Music Safari Registration Page

Parent/Caregiver 1 Name*

First Last

Parent/Caregiver 1 Email*

Enter Email Confirm Email

Parent/Caregiver 1 Cell Phone*

Texting*

YES, the School may send texts to this number.

NO, I do not want to receive texts on this number.

Parent/Caregiver 2 Name*

Please enter "N/A" in both fields if not applicable.

First Last

Parent/Caregiver 2 Email

Enter Email Confirm Email

Parent/Caregiver 2 Cell Phone

Texting

YES, the School may send texts to this number.

NO, I do not want to receive texts on this number.

Address*

Street Address City State ZIP Code

Student 1 Name*

First Last

Student 1 Date of Birth*

Student 1 Class Choice*

Spring Session Tuition: $450

Keyboard/Piano (Mondays) Kindergarten-Grade 2

Student 2 name

First Last

Student 2 Date of Birth*

Student 2 Class Choice*

Spring Session Tuition: $450

Keyboard/Piano (Mondays) Kindergarten-Grade 2

Total Due

Please use the PayPal Checkout button below. You do not need a PayPal account. You will be taken to a window that includes a gray Pay with Credit or Debit Card button. If you are paying by check, you will click the blue Submit button and mail in your check to the 10 Irving St address written out to PakMusic. Thank you!

Payment Method

Name

First Last

Option

Post Title

2024-2025 Music Safari

2025 Music Safari (Spring Session)

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