Registration Form Spring 2008

To enroll, please read courtesy information and registration guidelines, complete, print, then please mail or fax, 847-304-8963 this registration form with your $75 non-refundable deposit to:
Kindermusik Northwest, PMB #327, 117 South Cook Street, Barrington, IL 60010.
Spring 2008
All classes begin
the week of 1/28/08

Click here for our
registration guidlines
Village
Cock-A-Doodle Moo & Dewdrops
Total Classes 15
Class Length 45 min.
Materials $72
Tuition $165
Adult in attendance
Our Time
Away We Go
Total Classes 15
Class Length 35 min.
Materials $55
Tuition $155
Adult in attendance
Imagine That!
Toys & Trips
Total Classes 15
Class Length 45 min.
Materials $65
Tuition $165
Adult attends last 10 min.
Young Child I or II
Total Classes 15
Class Length 60 min.
Materials $60 (YC1)
$65 (YC2)
Tuition $185
Adult attends last 5 min.
Kids n' Musik Choir
Total Classes 15
Class Length 75 min.
Materials $45
Tuition $200
**Special Notes…

**Sibling Kits are available for Our Time, Imagine That! and Young Child levels of the program. If you are registering more than one child in the same level or have had an older child in that level - This reduces your fee. Please write sibling kit in pertient info space.

**$10 Sibling discount is given to every child after the highest tuition is paid in full.

**There are many concurrent class offerings if you have more than one child.

**The entire price for a class is Materials+Tuition

A $75 nonrefundable deposit per child is due at time of registration. The deposit will be applied to your total fee.
Parent/Guardian:
Mailing Address:
City/Zip:
Home Phone:
Work Phone:
Cell Phone:
e-mail:
Please identify who or how you were referred to KMNW?
1st Child's Name:
Birthday & Age by 9/1:
Day/Time (1st Choice):
Day/Time (2nd Choice):
Day/Time (3rd Choice):
Material Option: Full Materials Sibling Kit
Pertinent Information (medical or otherwise):

2nd Child's Name:
Birthday & Age by 9/1:
Day/Time (1st Choice):
Day/Time (2nd Choice):
Day/Time (3rd Choice):
Material Option: Full Materials Sibling Kit
Pertinent Information (medical or otherwise):
For payment we accept Visa, MasterCard, Money Order or Personal Checks
Cardholder Name:
Credit Card Number:
Exp. Date:
Billing Address:
City & Zip Code:
Please check one of the following
Apply my deposit only to this card
Apply my deposit to this card now and my balance due after 1/15/08

I, _________________________________________________ (please sign) hereby authorize Kindermusik Northwest to apply the total tuition and materials fee (less any applicable discounts) to my credit card.

I release any and all rights and claims for damages against Kindermusik northwest and it's Staff in the unlikely event of injury sustained by myself or my child(ren) during the course of this musical activity.

Sign Here:
Payment in full is due if registering after January 4th.