|

Kindermusik
with Marilyn Manzer
How
to Register your Child
Please
print out the registration form below, fill it in, and return it to 53
Pleasant St., Wolfville, N.S. B4P 1M9 with a cheque equal to at least
the amount of the registration fee. The balance
of the fee may be paid in one cheque postdated for January 15th 2008 or
two postdated cheques each for half the balance and dated January 15th
and March 1st 2008. Cheques are payable to Marilyn Manzer.
Back to home page
Registration Form
| Child's Name: |
| Parent's names: |
| Child's date of birth: |
Age as of January 2008: ____ |
| Mailing Address: |
|
Street
Address:
|
Home phone: Work phone (Mom): Work phone (Dad): |
| Email address: |
| Caregiver's name and phone number (if applicable): |
|
Parents
own or play any musical instrument? Specify:
|
| How did you hear of my Kindermusik classes? |
| Do you consent to the listing of your telephone number on a
class list? Yes / No |
| Do you consent for me to use photos of you and/or your child
in Kindermusik class on my website? Yes / No |
Class enrolled for: Village ___ Our Time ___ Imagine That
___
Kindermusik for the Young Child Year 1 (4-6 yrs) ___ Yr.2 (5-7 yrs) ___ |
| Class time preferred ___________________________ |
| Signature:_____________________ |
Date:_________________ |
|
|
___________ |
|
+ Balance of Fee
|
___________ |
|
= Total Fee
|
___________ |
|
- Discount for 2nd Child (10%)
|
___________ |
|
= Total with Discount
|
___________ |
|
Paid at time of registration:
|
___________ |
|
Post dated cheques: __________ and
|
__________ |
Back to home page
|