CMA Minot Pre-Junior Registration Form

CMA Minot: Pre-Junior Registration

A separate registration form must be completed for each student. Please provide your details and select your options below.
Student Name

First NameLast Name
Student Date of Birth

MonthDayYear
Date
Parent Name

First NameLast Name
Parent Email Address
example@example.com
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Can this phone receive text messages? (Message and data rates may apply.)
Address

Street Address

Street Address Line 2

CityState

Zip Code
Additional Contact (if someone other than parent may bring student to class)

Full Name

Relationship to Student

Email AddressPhone

Postal / Zip Code
Please indicate your availability (select all that apply). Please note: this is a scheduling aid only. New classes are not always available on selected days/times.
Student allergies, special needs, or other information you would like us to have:
How did you first hear about CMA Minot? If referred by an individual, please enter their name here.
Notice: Photography, audio, and video recording may occur at CMA classes and events. Your participation constitutes consent to such recordings for use in media in connection with CMA. We will not sell your likeness. Names will not be used without consent.
CMA Minot Pre-Junior Course
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Registration/Materials Fee and Tuition
Due upon registration. Enrollment is secured only once payment is received. Non-refundable if confirmed to a class. If we are unable to place student in a class, a refund will be issued.

$190
The Pre-Junior Course consists of 8 classes. No refunds will be issued for unattended classes. Invoices will be sent via email with an online payment option. Payments are preferred through ACH (automatic bank account withdrawal), but may also be made by check. Payments returned as non-sufficient funds will incur a $20 fee.
Parent Signature
Should be Empty:

CMA Minot: Pre-Junior Registration

CMA Minot Pre-Junior Course*

CMA Minot Pre-Junior Course