Music for Little Hands::featuring Kindermusik, birthday parties and instruments and gifts for little hands

Summer 2010 On-line Registration

Space for your child will be reserved upon receipt of a completed registration form with
payment in full. There are no make-up classes or credits available for missed classes.
Once registered, tuition and registration fee is non-refundable except in the case of a program canceled by Music for Little Hands. Contact the studio for discounts if you think you
already own the home materials for a particular theme.

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:

Class Level:

Start Datel:

1st Day/Time Preference

2nd Day/Time Preference

1st Sibling (or 2nd Class)

Birth Date:

Class Level:

Start Date:

1st Day/Time Preference

2nd Day/Time Preference

2nd Sibling (or 3rd Class)

Birth Date:

Class Level:

1st Day/Time Preference

2nd Day/Time Preference

Comments: Please give comments below. Please include any learning, medical or behavioral information for the teacher (all responses are confidential).

Figure Your Payment:

Oldest (or first class) payment amount	$
1^st sibling or 2nd class payment amount	+ $
2^nd sibling payment amount	+ $
Subtotal	= $
One-time, non-refundable $20 registration fee for NEW families:	+ $
TOTAL amount due with registration:	= $

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

By submitting this registration form and payment, it is understood that I have read the Studio Policies and agree to abide by them and that 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.

By submitting this registration form and payment, it is understood that
I have read the Studio Policies and agree to abide by them.