Kindermusik June 2013

Kindermusik Registration Form- Classes Start June 10 & 11

Complete the form below to sign up for Kindermusik. You must complete your payment via paypal after you have submitted your registration form in order for your registration to be complete.
Parent Name

First NameLast Name
E-mail
Cell Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Child Information
Child Name

First NameLast Name
Age
Birth Date

MonthDayYear
Emergency Contact Person
Phone Number
Relationship
Allergies
Second Child Information
Child Name

First NameLast Name
Birth Date

MonthDayYear
Allergies
Select Class:
Registration & Class Fee
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Village Registration and Home Materials$50.00

Wiggle & Grow Registration and Digital Home Materials$35.00

Laugh & Learn Registration and Digital Home Materials$35.00

Total $0.00
Should be Empty:

Kindermusik Registration Form- Classes Start June 10 & 11