Kindermusik Registration Form

     

    Name: 

      

    Age:       Date of Birth: 

     

    Address: 

     

    City, State, Zip: 

     

    Email: 

     

    Home Phone: 

     

    Parent(s) Name(s): 

     

    Work Phone: 

     

    Does the student have any health issues or concerns? 

     

    If yes, please list: 

     

    Free Trial Classes

    Thursday, September 15:     9:30am   10:15am

    Thursday, September 29:     9:30am   10:15am

     

    Thursdays

     9:30-10:00am (18 mo. - 3 yrs):    September     October     November 

    10:15-10:45am (18 mo. - 3 yrs):    September     October     November 

    11:00-11:45am (4yrs - 5 yrs):    September     October     November