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Kindermusik of Grapevine
Registration By Credit Card or PayPal for Spring 2010

To register, please fill out this form, hit ‘SUBMIT’, and then follow PayPal’s
payment directions. Follow this procedure for each child being registered.
To change your class selection, hit ‘RESET’.

Child’s Name:

Male Female

Birthdate:

Age when class begins:

Year: Month:

First Names & Ages of Siblings:

Parent/Guardian:

Address:

City/Zip:

Home Phone:

Cell:

Work:

E-mail:

Mom’s Occupation:

Dad's Occupation:

Parents’ Musical Training/Interests:

Nursery Needed? Yes No If 'Yes", Age of child:

How did you hear about Kindermusik?

Please Make Your Class Selection Below:

Payment Information: Includes materials and 15 classes (except Family Time, which has 10 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 817-481-4513 x200 for amount due.

By enrolling my child for this semester, I agree to pay the Full Tuition of $ from the class list above.