Kindermusik with Sherry - Registration Form

Kindermusik^® for the Young Child Class Ages: 5 to 7 years old	Registration Form Cost: (First Christian Church) $180 (materials included) for 15 weeks(75 minute classes) Cost: (Cohutta Elem. School) $200 for 15 classes (materials included - 75 minute classes) Discounts are available.
Choose Class Location:
Choose Class Dates, 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 play an instrument which you would be willing to demonstrate in class?: Yes No
If yes, which instrument?:
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.

For a printable PDF version choose one below:
Young Child