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Spring
Registration 2009 Nancy
Hall, Director Email: infokindermusik@aol.com You may email this form & call us with your credit card |
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Spring
Registration 2009 Nancy
Hall, Director Email: infokindermusik@aol.com You may email this form & call us with your credit card |
Please complete one form for EACH child you are enrolling.
Child’s Name___________________________________________________________ Male _______ Female_____ Special Needs? (Medical, Behavioral?)______________________________________________________________ Parent Name(s)__________________________________________________________________________________ Email for Weekly Emails (Please Print Legibly). Your address will NOT be sold or shared. ___________________________________________________________________________________ Address________________________________________________________________________________________ City____________________________________________________TX Zip_____________________ Home Phone_______________________________________ Cell Phone___________________________________ Mom's Work Phone__________________________________ Dad's Work__________________________________ How did you learn about us? ___Kid’s Directory ___ Our Website ___ Kindermusik International Website ____Online search ___Woodlands Online Website ___ Interfaith Phone Directory ___Other Phone Directory ___Newspaper Ad ___Flyers/where?_______________________ Friend/who?_________________________ Other/Explain_______________________
Sign & Sing (6 mo.-3 years)____ Day & Time________________ Regular Materials?______ Village (Newborn-18 mo.)_____ Day & Time______________________ Regular Materials?_______ extra sibling instruments?_______ Our Time (1.5-3.5 years)_____ Day & Time______________________ Regular Materials?_______ Sibling Materials?______ Family Time (Newborn-7 years)____ Day & Time_________________ One set of materials for your children to share Young Child (5-7 years) Yr 1___ Yr 2___ Day & Time______________ Regular Materials?____ Sibling Materials?____ Recorder?____ Special order materials____________________________ New student needs glockenspiel and bag also____ Tuition/Materials Amount $_________ Multiple Child Discount ($10 off additional child) --$____________ Early Bird Discount (Pay in FULL by Dec. 19, $15 off) --$_____________ Pro-rated amount --$ ______________ Grand Total $ ___________ Paid Today $___________ Balance $_____________ DUE January 23. Late fee $15 after Jan.31. _______Full Tuition Payment OR_____Down Payment paid by ____ Check #_________ ______ Credit Card ______Cash My Balance Due Option will be paid by: ____Attached post-dated check in the amount of $_______ dated Dec. 19 for Early Bird Discount ($15 off). FREE CD. ____Attached post-dated check in the amount of $_______ dated Jan. 23 Due Date. ____Attached 2 post-dated checks in the amount of $_______ (each one half the balance), and dated Feb. 20 and Mar. 27. ____Automatic credit card charge in the amount of $_____ on due date of Jan. 23. ____Automatic credit card charge in the amount of $_____(each charge one half the balance), on Feb. 20 and Mar. 27.
Credit Card #__________________________________________________ Expiration ______________ Name on Card_________________________________________________________ Credit Card Billing Zip Code_____________ Signature________________________________________________________ Date__________________________
Please Read, Sign & Date *If I am paying by credit card or debit card, I authorize Kindermusik of The Woodlands to charge the above indicated account on the due dates specified. *If I am paying by check and my check is returned for insufficient funds, I authorize Kindermusik of The Woodlands to collect a NSF fee of $30 and a new check or cash for the amount owed. *I understand that there are no refunds, except if there is insufficient enrollment for the class to make. *I understand that I am making a commitment to the length of the 15 week semester, and that missed classes may be made up only by visiting other spring classes if one exists and provided the class size is not exceeded. *Occasionally photos are taken of our students during class. I give permission to use photos of my children or myself in newspaper articles, ads, in studio marketing materials, and on the studio website. *I release any and all rights and claims for damages against Kindermusik of The Woodlands and its staff in the unlikely event of injury sustained by myself or my child(ren) during the course of or as a result of this musical activityl *I agree to pay any collection agency fees and late fees in the event that my account is delinquent. *I agree to pay a late fee of $15 if my balance is paid after January 23. (Late Registrants are not charged a late fee). *I agree to give WRITTEN NOTICE should I need to withdraw from the semester due to unusual circumstances. I agree to have a $30 withdrawal fee applied against the remaining tuition. I understand the Down Payment is forfeited and the remainder of the tuition will be accessed at the point in time where notice was given in writing and will be credited to my in-house accountfor up to 12 months and may be used for Kindermusik class TUITION only. I understand that I may withdraw by January 2 and receive a FULL REFUND.
Parent Signature____________________________________________________Date_______________
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