Kid’s Rockin The House

Let’s Make Music Loves Kids!! We can provide interactive music to get kids up and moving to the music! We have an extensive repetoire of music like “Wheels On The Bus” to “The Ants Go Marching in”.

We can also provide basic music education teaching kids the “do re me’s” of music as well as basic instrument instruction.

Know 4 or 5 children who would enjoy group lessons? We can do that!

Please see Program Policies for more details

Registration Form

Participant Name

First Name

Last Name

Participant Age

Parent/Caregiver Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Yes, I would like to register a family member:

Family Member Name

First Name

Last Name

Family Member Age

Getting to know you

Does the participant have any allergies, chronic illness, or medical conditions? If yes, please describe.

Please describe the dietary need of the participant (restrictions and preferences):

Are there any accessibility needs to be taken into consideration during programming:

Give Us Information That Will Make Our Time Together Better: (let us know of specific things like loud noises, vision, lights, that we need to take into consideration)

I understand that I am signing up for the entire session:

Yes

I agree to pay the amount specified for the Program:

Yes

Let’s Make Music Is On Social Media

Please let us know where we can use pictures of the participant:

Facebook

Instagram

Twitter

Website

PowerPoint During Presentations

Transfer of Care:

We are committed to offering quality programming for our clients. We believe it is extremely important to provide a safe, therapeutic and caring environment for our clients to grow. Please note that the individuals must be able to demonstrate a basic ability to are for their personal needs while attending programming. To ensure the safety of your loved on, we do not offer Transfer Of Care.

I have read and understand the Transfer of Care Policy:

Program Policies

Youth Programming

Kid’s Rockin The House

Let’s Make Music Loves Kids!! We can provide interactive music to get kids up and moving to the music! We have an extensive repetoire of music like “Wheels On The Bus” to “The Ants Go Marching in”.

We can also provide basic music education teaching kids the “do re me’s” of music as well as basic instrument instruction.

Know 4 or 5 children who would enjoy group lessons? We can do that!

Please see Program Policies for more details

Registration Form