Mulberry Bush Credit Card Order Form

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MAIL IN REGISTRATION FORM - WINTER SESSION 2012

(For mail order registration, please fill out this form and mail it to the address below.)

MOVERS AND SHAKERS: Ages newborn through four years, with parent or caretaker.
Each 10 week session is $180.00. Each sibling is $120.00. (Siblings 0-6 months are free)

"Sign Up With A Friend" Discount - Click Here!

Mulberry Bush Music on Mercer Island!
MOVERS AND SHAKERS
Tuesdays: 10:30 - 11:15
Community Center at Mercer View
Registration Now Open - Click Here!

Wednesdays, 10:30 - 11:15 am
January 11 - March 21
Mt. Baker Community Club
2811 Mount Rainier Drive South

No class Feb. 22 - 10 week session

10 Class Session: Fee $180
10 Class Session: Sibling Fee $120

Continue for Spring Session (April 4 - May 30)
9 Class Session: Fee $162
9 Class Session: Sibling Fee $108

MUSIC KIDS: Ages 2 through 5 years, with parent or caretaker.
Each 10 week session is $180.00. Each sibling is $120.00.
(Siblings 0-6 months free - Please email regarding fee for siblings ages 6 months - 3 years.)

"Sign Up With A Friend" Discount - Click Here!

Mondays, 10:30 - 11:15 am
January 9 - March 26
University Heights Center
5031 University Way NE

No class Jan. 16 and Feb. 20 - 10 week session

10 Class Session: Fee $180
10 Class Session: Sibling Fee $120

Continue for Spring Session (April 2 - June 4)
9 Class Session: Fee $162
9 Class Session: Sibling Fee $108

No class May 28th

If you would like to add a copy of Hilary's award-winning release
."Cantilena: Night Songs from Around the World," at a special
.."student discount" price of $13, including shipping,
..please check this box.

One Copy of "Cantilena" (~~$16~~ $13 inc. shipping)

If you would like to add a copy of Hilary's award-winning release
."Siente: Night Songs from Around the World," at a special
.."student discount" price of $13, including shipping,
..please check this box.

One Copy of "Siente" (~~$16~~ $13 inc. shipping)

Registration and Credit Card Information

Child's Name: (Sibling Name)
Child's Birthday: (Sibling Birthday)	... ... ... ...
Parent's First Name:
Last Name:
Address:
City:
State:
Zip:
Daytime Phone:
Email Address:
"Sign Up With A Friend"*	........((Optional. See "Sign Up With A Friend" Page for details!)
Credit Card Number:	........((Visa/Mastercard Only)
Expiration Date:	.....
Security Code:	........................................................ What's the Security Code?
If you would like to register online, using a credit card or PayPal, please visit our Web Order Registration Page. To register by mail, please fill in all the information above, print out the form, and sent it, along with a check or money order, to: Mulberry Bush Music and Movement 9102 17th Avenue NE Seattle, WA 98115-3212
............
For More Information Feel free to contact us at: Mulberry Bush Music 9102 - 17th Avenue NE Seattle, WA 98115-3212 Phone/Fax: (206) 686-2201 Email: Please use our CONTACT form.