Kindermusik - Registration for 2024/2025

Benson School of Music - Kindermusik Registration

Registration for Kindermusik classes Level 1 (ages 1-2 years) , Level 2 (ages 2-3 years), and Level 3 (ages 3-5 years)
Student Name*

First NameLast Name
Student Birth Date*

MonthDayYear
Main contact name(s)
Main contact email address (1)
example@example.com
Main contact email address (2)
example@example.com
Student Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main contact cell number (1)

Area CodePhone Number
Main contact cell number (2)

Area CodePhone Number
Choose your preferred class level and class day/time. NOTE: LEVEL 1 and LEVEL 3 classes are all currently FULL ,*

LEVEL 1 (ages 1-2 years): SATURDAYS at 9:00am with Miss ElizabethLEVEL 1 (ages 1-2 years): SATURDAYS at 10:00am with Miss ElizabethWAITLIST ONLY: LEVEL 2 (ages 2-3 years): SATURDAYS at 11:00am with Miss Melody *class is currently full*WAITLIST ONLY: LEVEL 3 (ages 3-5 years): SATURDAYS at 12:00pm with Miss Chloe *class is currently full*
Is there anything we should know about you? (allergies, family needs, etc)
Were you referred to our program by a BSoM family? If so, please name here
I acknowledge that by providing my electronic signature, I realize that photos or video may be taken in class for the use of educational and promotional purposes. I understand that if my preference is to NOT have photos/videos shared on social media, I must email jenniferbensonmusic@gmail.com to notify our office.

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I acknowledge that I have read and agree to the Benson School of Music Studio Policies

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Fees due upon registration (non-refundable)

Kindermusik Registration Fee$25.00CAD

Non refundable. Registration fee for Kindermusik classes.

Quantity

Total $0.00CAD

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Credit Card Number	Security Code
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Benson School of Music - Kindermusik Registration