Spring 2011 Session will be a 10-week session from Mar. 7 - May 20. No class during spring break; make-

ups week of May 22, if needed. Please indicate preferred enrollment option.

Child’s Name: ____________________________________ Birthdate: ______________

Early Childhood Music & Movement Classes

Registration Form: Spring 2011 Session

INFANT/TODDLER CLASSES (Birth-3)

___ Tuesday, 5:30-6:15pm ($150)

___ Saturday, 10-10:45am ($150)

PRESCHOOL CLASSES (3-5)

___ Tuesday, 6:30-7:15pm ($150)

___ Saturday, 11-11:45am ($150)

Providing Creative Opportunities for Developing Abilities

Indicate Payment Method: Cash___ Check___ Money Order___ Make checks payable to: CODA Music Therapy Services, LLC

___ Paid in full ___ Pay in two installments, balance will be due APRIL 16

P.O. Box 81003 Lansing, MI 48908 www.codamts.com (517) 862-4675

The Early Childhood Division of

___ Yes, I qualify for the Military Rate ($120)

___ Yes, I have already registered another child for SPG Classes. Sibling Rate: $120

Name of sibling: ________________________________

___ Yes, I have a discount coupon! (May not be combined with military or sibling rate.)

Coupon code: __________ Discount Amount: ________

___ Yes, I am registering by February 25, 2011. Early Bird Discount: $10 off

(Early Bird Discount may be combined with other discount.)

Registration Cost: ________

Discount Amount: ________

Registration Total: ________