Kindermusik with Sherry - Registration Form

Kindermusik^® ABC Music & Me Class Ages: 2 to 3 years old	Registration Form Cost: (First Christian Church) or (Cohutta Elementary School) $45 per month (four 45-minute classes) Cost: (Varnell Praise & Play Preschool) $148 if paid in full by January15. Otherwise, $40 per month. (16 weeks) Discounts available for prepayment of 3 months. All materials included (30 minute classes) Discounts are available.
Choose Class Location:
Choose Class Date, Time, Semester:
Child's Name: *	Boy or Girl: *
Date of Birth: * Day: Year:
Name and ages of siblings
Sibling's Name:	Age:
Sibling's Name:	Age:
Sibling's Name:	Age:
Sibling's Name:	Age:
About Parents
Parent Name: *	Parent Name:
Mailing Address: *
City: * State: * Zip: *
Home Phone: * Work Phone:
Cell Phone:
E-Mail Address: *
Child's Teacher: (if applicable)
Previous Kindermusik Classes?: Yes No
If yes, please list:
If new, how did you hear about this class?:
Do you know anyone who would like to hear about Kindermusik?
Their Name:	Phone:
Their Name:	Phone:
Tell me one benefit you would like for your child to derive from this semester in Kindermusik.

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