FREE Kindermusik Demo Class

REGISTER NOW FOR SUMMER 2008 CAMPS!!!
Registration Form Summer 2008
fill-in form fields and print regirstration.

PLEASE SEND REGISTRATION AND MAKE CHECKS PAYABLE TO
Kimberly R. Denney, Kimberly’s Kindermusik, 414 Terrace Creek Court, Lebanon, Ohio 45036
Summer 2008
June - August

Click here for our
Courtesy Information
Peek-A-Boo
Tuition &
Home Materials		 $85
Zoo TRain
Tuition &
Home Materials		 $90
On the Road
Tuition &
Home Materials		 $120
Tell Me a Tale or
Around the World
Tuition &
Home Materials		 $140
Sign & Sign
Tuition &
Home Materials		 $80

All other classes please register online!
Parent's Name:
Address:
City/Zip:
Home Phone:
Day Phone:
e-mail:

for class time confirmation

How did you hear about the Kindermusik program:

List any medical or behavioral conditions of which the Instructor should aware:
Child's Name 1:
Age/Birthday:
Time:
Total Due Child 1: $
Child's Name 2:
Age/Birthday:
Time:
Cost:
$
- $10.00 Family Discount
Total Due Child 2: $
Child's Name 3:
Age/Birthday:
Time:
Tuition (50% off): $
Total Due Child 3: $
Grand Total $
I do hereby release and forever discharge Kimberly R. Denney, her studios, the studio teachers, and owners of any facilities where she teaches, from any and all actions, claims and demands for, upon or by reason of damage, loss of personal injury which may be sustained by my child or myself during the course of or as a result of this musical activity.
* Signature
Please Sign
Date:

Payment Options are available please contact Kimberly for more information.
Registration/Material fee is due with your registration form.