The document provides information about registering for early childhood music and movement classes offered by CODA Music Therapy Services for the Spring 2011 session. It includes a registration form detailing class times and payment options, as well as an enrollment form requesting child and parent/guardian contact information and permissions. The 10-week session runs from March 7 to May 20 with discounts available for early registration, siblings, military families, and coupon codes.

1. The Early Childhood
Division of
P.O. Box 81003  Lansing, MI 48908
www.codamts.com  (517) 862-4675
Providing Creative Opportunities for Developing Abilities
Early Childhood Music & Movement Classes
Registration Form: Spring 2011 Session
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: ______________
INFANT/TODDLER CLASSES (Birth-3) PRESCHOOL CLASSES (3-5)
___ Tuesday, 5:30-6:15pm ($150) ___ Tuesday, 6:30-7:15pm ($150)
___ Saturday, 10-10:45am ($150) ___ Saturday, 11-11:45am ($150)
___ 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: ________
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

2. The Early Childhood
Division of
P.O. Box 81003  Lansing, MI 48908
www.codamts.com  (517) 862-4675
Providing Creative Opportunities for Developing Abilities
Early Childhood Music & Movement: Enrollment Form
Child’s name: ___________________________________________ Birthdate: ____________________
Parent/Guardians’ name(s): ___________________________________________________________________
Address: __________________________________________________________________________________
City: _____________________________________________ Zip: ________________________
Phone: (____)________________________ E-mail: ________________________________________________
What kinds of music & movement experiences does your child receive at home? ________________________
__________________________________________________________________________________________
Does your child have any special needs and/or allergies? ___________________________________________
__________________________________________________________________________________________
Is there anything else important for us to know about your child? ____________________________________
__________________________________________________________________________________________
____ Yes, photos and/or video of my child participating in CODA MTS ECM&M classes may be used in
advertising (print and/or web-based) and/or professional presentations.
____ No, photos/video of my child may not be used by CODA MTS.
I agree to enroll my child in Sing Play Grow classes with CODA Music Therapy Services, LLC. I understand
payment is due at the time of registration. I understand that a parent/guardian must attend classes with my
child and I am responsible for the care of my child.
Parent/Guardian Signature: ____________________________________________ Date: __________________