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CREDIT CARD FORM - SPRING SESSION 2010

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


MOVERS AND SHAKERS: Ages one through four years, with parent or caretaker.
Each 10 week session is $160.00. Each sibling is $110.00.
"Sign Up With A Friend" Discount - Click Here!

EARLY BIRD SPECIAL - $150/$100 BEFORE MARCH 25TH

Wednesdays, 9:05 - 9:50 am
April 14th - June 16th
Mt. Baker Community Club
2811 Mount Rainier Drive South

10 Class Session: Fee $160.00 $150 exp 3/15
10 Class Session: Sibling Fee $110.00 $100 exp 3/15
Wednesdays, 10:05 - 10:50 am
April 14th - June 16th
Mt. Baker Community Club
2811 Mount Rainier Drive South
10 Class Session: Fee $160.00 $150 exp 3/15
10 Class Session: Sibling Fee $110.00 $100 exp 3/15
Thursdays, 10:05 - 10:50 am
April 15th - June 17th
University Heights Center
5031 University Way NE
10 Class Session: Fee $160.00 $150 exp 3/15
10 Class Session: Sibling Fee $110.00 $100 exp 3/15


Registration and Credit Card Information

Child's Name:
Child's 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?

To send this registration, hit the "send it in" button. If you're concerned about security,
or would just prefer to register via mail, you can also fill in all the information,
print out the form, and sent it to:

Mulberry Bush Music and Movement
9102 17th Avenue NE
Seattle, WA 98115-3212

............

Back to topAbout Security

You might have noticed we are not using a secure server for this form. Technically, sending your credit card information should be safe all the way to our mail box. However, although it's unlikely and there is no record of it ever happening, there is always a chance that the information can be intercepted. In fact, although we were planning to change the form submission policy to a secure page, in all of the cases of stolen credit cards that have been documented, none were obtained through Email communications; they were all stolen from html pages on "secure" sites. Anyway, if you would prefer not to send your credit card information this way, please fill out everything EXCEPT the actual credit card number. Then, call (206) 686-2201, and leave your name, credit card number, and expiration date on the Message Machine.Of course, you can always print out this page, with all of the information filled in, and mail it to us at the address above.


 

Back to TopFor More Information

Feel free to contact us at:

Mulberry Bush Music
9102 - 17th Avenue NE
Seattle, WA 98115-3212

Phone: (206) 686-2201
Fax: (206) 527-3546
Email: info @ mulberrybushmusic.com

Teachers

Hilary @ mulberrybushmusic.com