Registration

*For Credit Card payments and registration, click the Payment link above or CLICK HERE:

For payment via MAIL, print and mail the following to the address at the bottom.
Make sure to include FULL payment.

Name (Parent’s):________________________  Caregiver_____________________

Address: ____________________________________________________________

City: ___________________________ State: ____  Zip Code: ________________

Home Phone: (____)______________ Work / Cell Phone: (____)________________

E-mail: ______________________________________________________________

Child #1: ____________________________  Birthday: _______________________

Child #2: ____________________________  Birthday: _______________________

Which Session? (Summer / Fall / Winter / Spring) : __________________________

First Class Choice  Location_______________________________

Second Class Choice Location_____________________________

NEW FAMILIES: How did you hear about us? Thank you!_______________________

_______________________________________________________________________

*If you have a different summer and winter address, please give both.

 Please list the day and time of the class you would like…. Course fee
 First Choice (day/time)    $250
 Second Choice (day/time)    —
 Summer Session (day/time)    $200
 Sibling Fee (reduced rate for siblings in same class, child 6 months or less in same class – no charge)    $150
 Registration Fee (New Families: $15.00 non-refundable)    $15
 Total Payment (Registration will be confirmed by mail, email or phone.)    $

Make check payable to Ina Ferrara and mail to:

Music Together by the Dunes · PO Box 1189 · Quogue · NY 11959 · Tel# 631-680-1392