My First Music

Discovery Class®

featuring materials from

Birthday Party
Reservation Request Form

* 1. Birthday Child's Name:

* 2. 1st Choice of Date and Time for your party:

Date and Time:

* 3. 2nd Choice of Date and Time for your party:

Date and Time

* 4. Birthday Child is turning how old? (months or years)

* 5. If you want to request a particular teacher, which one?

* 6. For the location you have reserved (a home or a party site), please provide the following information.

Name

Company

Address 1

Address 2

City

State

Zip

Email Address

* 7.
Phone number at party location:

* 8. Party Organizer:

* 9. Home Phone of Party Organizer

* 10. Work phone of Party Organizer:

* 11. Cell phone of Party Organizer:

* 12. Email address of Party Organizer

* 13. Is the Party Organizer Related to the Birthday Child?

Yes

If yes, how are you related to the Birthday Child?

* 14. If not related to the Birthday Child, please provide the following information about the Birthday Child's parent(s):

Name(s):

Cell Phone(s):

Home Phone(s):

Work Phone(s):

Email(s):

Street Address

City/State/Zip

* 15. Number of Guests (15 children maximum including the Birthday Child):

* 16. You may request up to 5 favorite songs from The Music Class(R) CDs (name the collection on which the song appears if you know it):

Favorite 1:

Favorite 2:

Favorite 3:

Favorite 4:

Favorite 5:

* 17. Base Fee for the Party:

At your Location: $210 (includes everything listed in Terms and Conditions!)

* 18. For your off-site party, how many Special Birthday CDs do you wish to order at $6.50 per CD (minimum 4)? Also enter the total cost (calculate # of CDs x $6.50):

Number of Birthday CDs (8 min.):

Total Additional Cost for the CDs:

* 19. 7% sales tax on total cost of CD's only:

Cost of CDs (above) x $0.07 sales tax:

* 20. Total Amount Due:

Add Base Fee, Additional CDs, and Sales Tax from above PLUS $12 S&H if you are ordering Birthday Party CDs:

* 21.
Please read carefully the Birthday Party Terms and Conditions (click here to open, read, and download).
By Answering "Yes," below, you are acknowledging that you have read and understood these Terms and Conditions and agree to them.

Yes

We are not notified that you filled out this Reservation Form. Please email us to let us know you did so and then, during business hours, also please call our office (P: 404-314-4536) the following Visa or Mastercard information: (1) Name on the card, (2) card number, (3) expiration date, and (4) billing address.

A $75.00 Non-Refundable Deposit for the party AND the Non-Refundable cost of the CDs (CDs, sales tax, and S&H) will be charged upon your submission of the reservation and transmission of the credit card information. After we have received your payment information, you will receive a confirmation email indicating that your reservation has been received and processed and your deposit has been charged.

Submitting this reservation request alone will not secure your party reservation until and unless you also contact us by email and/or phone and also provide the credit card information.

The balance due (as itemized in the confirming email) will be charged five (5) business days prior to the party date.

* 22. I authorize My First Music Discovery Class, LLC, to charge my credit card as described above for the Birthday Party being requested by this submission according to these terms.

Yes

* 23. If you have any special requests, comments, or information you wish to include, please provide them here.

Before clicking on "Submit," below, if you wish, please print out a copy of this page for your records.

If you have any questions, special requests, comments, or information that you did not include above (or you ran out of space), email us (birthday@musicdiscoveryclass.com) or call the office (404-314-4536).

Thank you for choosing My First Music Discovery Class® for your Birthday Party!