Driving directions: Take 101 to Rowland Blvd exit. (Target exit.) Exit freeway and head West on Rowland. Very shortly, take a right onto Redwood Blvd. Take Redwood Blvd to Landing Court, and turn right onto Landing Court, at light. Pull into the Novato Center parking lot on your right. Ample parking right outside our classroom door.

Fill in the form completely, and click SUBMIT below.

(Or you can print the page and send to: Melissa Ayotte, 65 Lovejoy Way, Novato CA 94949)

To read class descriptions Click Here

Personal Information

Parent First Name Parent Last Name

Email Phone

Child 1 First Name Child Last

Child’s Birthdate Child’s Age Today

► If enrolling siblings in the same class fill in the next section, if not skip to STREET ADDRESS

Child 2 First Name Child Last

Child’s Birthdate Child’s Age Today

Street address

City State Zip

Person who will bring child to class

This person’s Cell phone number

How did you hear about my Kindermusik program?

If a friend referred you, may I have that person’s name so I might thank them?

Class Information

Registration Fee includes tuition fee and Home Materials: CD’s Books Activity Guide & Instrument.

Choose Class Day & Time

Type in your total registration fee

►Babies under 5 months take off 25%!!

►Enrolling siblings in the same class? Double the registration fee, then subtract 25%.

Choose a payment method

MC / VISA Number expiration

Billing Zip Code for this card:

Checks send to: Melissa Ayotte 65 Lovejoy Way, Novato CA 94949

Paypal users please follow instructions at the bottom of this page.

► Enrollments are confirmed upon receipt of payment

Classroom & Program Policies

Your registration is contingent on making sure you and your child’s adult participant understands the following classroom rules / program policies. Please take a minute to read carefully, everything here is important.

ADULT PARTICIPANTS:

· No food, drinks, toys, or strollers allowed in building or classroom, leave these items in the car.

· Adults participate by modeling for the child: singing, dancing, playing instruments, and acting silly are some of what the adult participant will do.

· All participants need to wear socks, and wash hands before class.

· Please arrive a couple minutes early to settle in to class, but not more than 5 minutes early as this interrupts class preparation time.

Bringing siblings to the same class Siblings (Twins or otherwise) may participate with one adult in “Our Time” 18 months to 4 years IF they are both within the age range of the program. Twins will each need a class participant for “Village” (Newborn to 20 months).

Disrupting Class If a child causes a disruption to others such as uncontrolled running, throwing things, or loud screaming/crying, his/her adult participant must calmly and quietly step out of the room with the child, request that the child stop the behavior, and rejoin the class when child has relaxed.

Sending another adult in your place: Dads, Aunts, Grandparents, Nannies etc. are all welcomed as adult class participants. It is YOUR responsibility to communicate the items on this list to anyone else you send to class as your child’s class participant.

Refunds. Your registration fee is refundable up to 24 hours after the first class meeting, minus a $10 processing fee and materials fee for any opened materials. After this time, absolutely no refunds are available. (Credit may be issued in extreme circumstances and considered on an individual basis.)

Make ups are offered but not guaranteed One or two are offered during the current session only, if I have room in another class of your child’s age range (I usually do.) Make ups are a courtesy, they are in no way guaranteed as part of your enrollment. Please request make ups promptly via EMAIL, thank you.

Sick children and sick adults are not allowed to come to class. Use your own good judgment here please.

Unenrolled children / siblings are not allowed to visit. If I have room, you may be able to bring a sibling for an additional drop-in fee. Please contact me with 24 hours notice to arrange this. Grandparents, caregivers are welcome to accompany you to class any time.

► Have you read the above information carefully? Yes No

Photo / Video release: By enrolling in Kindermusik, you agree to the release of any class photo or video clip that may contain an image of you or your child participating in class activities. Names never released, personal information never shared with anyone.

Insurance release: By enrolling in Kindermusik you agree to release, waive and discharge Music with Melissa, the OptimaLearning Center, PS Business Park, Lanham Village HOA, and Melissa Ayotte from any and all liability for any injury, loss, or property damage, arising out of or in any way connected with participation by the undersigned or the enrolled child in the program; before, during, or after class; indoors or outdoors.

► Do you agree to the above releases? yes …...(this is Required)

Is there anything else you feel I should know?

Click below to submit your registration form.

I will contact you within the next 2 business days to confirm receipt of form, thank you!

Pay Pal Users:

If you are using paypal today, submit the form first then go to www.paypal.com and send your registration fee to m1@musicwithmelissa.com