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{1,2,3, Learn Ukulele} Registration

Register here for 1-2-3, Learn Ukulele. Once you hit the "submit" button, you will be directed to complete your payment via PayPal or credit card.

First Child's Name*
First Last
First Child's Date of Birth*
Second Child's Name*
First Last
Second Child's Date of Birth*
Your Name*
First Last
Email*
Phone*
Photo & Video Release*
Photos and videos may be used for promotional purposes on our website, social media, and print materials. If you do not grant permission, photos and videos of your children will not be used outside of class for any reason.
Special Considerations
Please list any allergies, special needs, or other issues so that your children can be best served during the course of this class.

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Music Therapy Connections | 1234 Centre West Drive | Springfield, IL 62704