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Licensed Kindermusik Educator
(281) 384-4507
kindermusikwithjulie@hotmail.com
Fall 2007 Registration
One form per child, please. Please complete ALL the information.
Child’s name __________________________ Birthdate ____________ Age 9/1/07 ___
Mother’s name _________________________ Hm. Phone ________________________
Father’s name __________________________Wk./ Cell _________________________
Address _________________________________
City ___________________ TX Zip ____________
E-mail address _______________________________
Please indicate a 1st and 2nd choice for class day and time.
Village ________ 1st choice _________________ 2nd choice ____________________
Our Time _____ _ 1st choice _________________ 2nd choice _____________________
Imagine That ___ 1st choice _________________ 2nd choice _____________________
A Down Payment of $65.00 is due with this form to reserve your place in class and cover the cost of materials. Please mail your check and this form to Julie Evans at the address below.
Total cost is ____________. Today I am paying _____________.
My balance is ______________ due on Nov.1st. Check here if you wish to split the balance into two payments due Oct. 1st and Nov.1st. _________
I understand that I am making a commitment to the entire 15 week semester and that missed classes may be made up by visiting other classes. I understand that my Down Payment and Tuition are NON-REFUNDABLE.
Parent Signature _________________________________ Date_________________
Please send this form and your check payable to: Julie Evans, 4803 Diehlwood Place, Spring, TX 77388
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