Do Re Me Music 2009-2010 Registration Form
Please print and fill out the registration form. Mail it along with registration fee and Direct Payment Authorization Form
to Do Re Me Music at 309 Cane Bend Drive Haughton, LA 71037.
Registration Date:______________________
Parent/Caregiver Name:_______________________________________________________________
Child's Name:______________________________________________ Gender M or F
Child's Birth Date:____/____/______ Age:__________
Address:______________________________________________________________
City__________________ Zip____________
Phone:________________________________ Secondary Phone:_______________________________
Email Address:____________________________________________________________________________
How did you hear about us? _________________________________________________________________
Class: (Circle One)
Village (0-18 mo) Our Time (18 mo-3 yrs) Imagine That (3 - 5 yrs) Young Child (5 - 7 yrs)
Location : Grace Community Methodist Church
Registration Fee Due: $60
Make Check payable to Do Re Me Music
Send registration form and check to: 309 Cane Bend Drive Haughton, LA 71037
Questions? Call Susan Smith at 318-347-2881 or Jennifer Tuxen at 318-560-1821