Child’s Name      Birthdate      Male    Female 
  Age When Class Begins     First Names & Ages of Siblings 
  Name(s) of Parent/Guardian 
  Street Address City   Zip
  Home #   Cell # E-Mail Address
  Mom’s Occupation     Dad’s Occupation
  Parents’ Musical Training & Interests
  How Did You Hear About Kindermusik? Select One Referred by a Friend Magazine Ad Web Search Heard About it at Church
  Please Select Your Class & Session From Just One of the Drop Down Lists Below:
          Village (Newborn to 18 Months) Camp Fee $95 Select a Class Session 1 Busy Days Wed 11-11:45 AM Grapevine (N) Session 2 Peek A Boo T/Th 11-11:45 AM Grapevine (N) Session 3 Busy Days Th 11-11:45 Colleyville Session 4 Peek A Boo W/F 11-11:45 AM Colleyville
          Our Time (18 Months to 3-1/2 Years) Camp Fee $95 Select a Class Session 1 Zoo Train Wed 9-9:45 AM Grapevine (N) Session 1 ZooTrain Wed 10-10:45 AM Grapevine (N) Session 2 Creatures T/Th 9-9:45 AM Grapevine Session 2 Creatures T/Th 10-10:45 AM Grapevine
          Imagine That (3 to 5 Years) Camp Fee $95  Select a Class Session 1 On the Road Wed 12-12:45 Grapevine Session 2 Confetti Days T/Th 12-12:45 Grapevine Session 3 On the Road Th 12-12:45 Colleyville Session 4 Confetti Days W/F 12-12:45 Colleyville
          Family Time (Newborn to 5 Years) Camp Fee   Select a Class Session 3 Zoo Train Th 10-10:45 AM Colleyville Session 4 Creatures W/F 10-10:45 AM Colleyville
                 ($95 1st Child, $65 Each Additional Child)                      (N) Nursery available at no charge

Payment Information: Fee includes materials and classes. Because the schedule of classes is set and contracted salaries are based upon enrollment in each class, there will be no refunds. In case of medical emergency, partial credit can be applied to the following semester.

Late registration will continue as long as space is available, and tuition will be prorated based on when student begins attending class.Call Mary Diane at 817-481-2559 x200 for amount due.

AGREEMENT
“By enrolling my child for this semester, I agree to pay the full tuition from
the class list above with payment through PayPal or credit card.”