Child's Name_______________________ Birthdate_____________________
Child have any food allergies? __________________________________________
Parent's Name_________________________________Phone_____________________
Address_____________________________City_______________Zip______
Class
(Check one) Village___Our Time___Imagine That!___Young Child I____
Day ____________Time___________Teacher__________________Amount Enclosed_________________
Referred By_____________________________________________________
Email address___________________________________________________
| Mail Registration to: | Magic Music Studio | |
| 5440 SW 190th Ave. | ||
| Aloha, OR. 97007 |
| Questions????: | Dianna Himes | 503-642-4734 |
Send email to:Dianna_Himes@magicmusicstudio.com
Or visit our web site at Magicmusicstudio.com