Green Grass Music
Registration Form


Child's Name:

Child's Birth date:

Parent's Name:

Address:

E-mail:

Phone:

Emergency Contact:

Title of Class:

Day/Time:

How did you hear about these classes?:

Referred by?:

Special Needs/Considerations?:



Home Kit Materials fee is due at time of registration.

PAY ONLINE! CLICK HERE

or mail registration and check to:

Missy Barker
9036 SE Morrison Street
Portland, OR 97216

Class Location:
The Academy Theater
7818 SE Stark Street
Portland, OR 97215

Call Missy Barker at Green Grass Music with questions
503-234-6988