Parent's Name
Home Phone:
Re-enrolling family address and phone on file. Indicate any changes below.
Address:
City:
Zip Code:
Cell Phone:
E-mail Address
Oldest Child's Name:
Birth Date:
Fall '08 Spring '09 Both Fall'08 and Spring '09
Class Level:
1st Day/Time Preference
Location
Monroe Oxford New Milford
2nd Day/Time Preference
1st Sibling (or 2nd Class)
Birth Date:
Fall '08 Spring '09 Both Fall'08 and Spring '09
Class Level:
1st Day/Time Preference
Location
Monroe Oxford New Milford
2nd Day/Time Preference
2nd Sibling (or 3rd Class)
Birth Date:
Fall '08 Spring '09 Both Fall'08 and Spring '09
Class Level:
1st Day/Time Preference
Location
Monroe Oxford New Milford
2nd Day/Time Preference
Comments: Please give comments below. Please include any learning, medical or behavioral information for the teacher (all responses are confidential).
Choose from payment options below:
Pay in full for one semester (for classes already in session please contact the studio for pro-rate information)
Pay in full for both Fall & Spring Semester (not available after 10/1/08) and deduct $40 for the year. Note : Full Year Registration Required for Young Child students see current schedule for tuition rate.
Four equal payments Payments will be charged automatically to credit card below with 1st payment and non-refundable Registration Fee (new families only) at time of registration and remaining 3 payments on the 1st of the month in Oct, Nov and Dec of 2008 for the Fall Session or Mar, Apr and May for the Spring Session. Add a $5 installment charge to each payment.
Eight equal payments Full year registration only - Payments will be charged automatically to credit card below with 1st payment and non-refundable Registration Fee (new families only) at time of registration and remaining 7 payments on the 1st of the month in Oct, Nov, Dec of 2008 and Jan, Feb, Mar and Apr of 2009. Add a $5 installment charge to each payment.
Discounts: Siblings or additional classes: 10% discount for additional classes within the immediate family for children registered in different classes. 50% discount for second and additional children registered for the same level and the same day and time (includes one set of home materials per family). There is no additional home materials discount for siblings registered in the same class. Additional home material components must be purchased separately.
Figure Your Payment(s): (according to the payment option chosen above)
Don’t forget to double the semster fee if paying for the full year)
Music for Little Hands, LLC has my permission to use my child's and my photograph in future publications, web pages and other promotional materials used by and representing Music for Little Hands, LLC. I understand that there will be no compensation to me for this use.
Yes No
I do hereby release and forever discharge Leslie Waddell and any employees or contractors of Music for Little Hands, LLC from any and all actions, claims and demands for, upon or by reason of damage, loss or personal injury which may be sustained by my child or myself during the course of or as a result of this musical activity, to the extent permitted by law.
I Accept the Terms I Decline
By submitting this registration form and payment, it is understood that I have read the Studio Policies and agree to abide by them.