KINDERMUSIK OF FARR WEST AND PIANO

SUSAN LARSEN/DIRECTOR PHONE: 782-8143

1576 Farr West Drive Farr West, Utah 84404

FALL REGISTRATION 2010

NAME:_______________________________________AGE:_______
BIRTHDATE:___________PARENT NAMES:_____________________
PHONE:____________________CELL PHONE:__________________
ADDRESS:___________________E-Mail:_ ___________________

CHECK and CIRCLE THE CLASS YOUR CHILD WILL BE IN

___________KINDERMUSIK OUR TIME: (MILK AND COOKIES) TUESDAY, 9:45 A.M.-
10.40 A.M., and 11:00 A.M.-11:55 A.M. WEDNESDAY, 9:45 A.M.-10:40 A.M., and
11:00-11:55 A.M. THURSDAY, 9:45-10:40 A.M. A $60.00 Material fee, or a $10.00
Material fee for children already owning material is due the 1st of August. This fee will
be a deposit for holding your child's place in this class. Material fees received after
August 1st, add an additional $7.00 for shipping. Tuition will be $80.00 each semester or
$25.00 a month for September, October, November and December. THIS CLASS IS FOR
CHILDREN 18 Months to 3 years of age. Parents are required to attend.

___________KINDERMUSIK IMAGINE THAT: ("HELLO WEATHER, LETS PLAY

TOGETHER) MONDAY, 9:45 A.M.-10:45 A.M., or 1:00-2:00 P.M., and TUESDAY
1:00-2:00 P.M., A $70.00 Material fee for continuing students, a $75.00 Material fee
for new students (which includes a backpack), or a $10.00 Material fee for children
already owning material is due the 1st of August. This fee will be a deposit for holding
your child's place in this class. Material fees received after August 1st, add an additional
$7.00 for shipping. Tuition will be $85.00 each semester or $30.00 a month for
September, October, November and December. THIS CLASS IF FOR CHILDREN 3 1/2 to 5
years of age. Parents are required to attend the last 10 minutes of class for sharing
time.
_________________________________________________________________________________________________
Please Detach
Parent Information

A SEMESTER IS 15 WEEKS. FALL SEMESTER CLASSES BEGIN THE WEEK OF September 7th, 2010, AND WILL END
THE WEEK OF December 13th, 2010. There will be a Thanksgiving break the week of November 22nd-27th. IF
PAYING TUITION MONTHLY IT WILL BE DUE BY THE 10TH OF EACH MONTH, OR A $15.00 LATE CHARGE WILL BE
ASSESSED. CHECKS ARE MADE PAYABLE TO SUSAN LARSEN

OUR TIME: A $60.00 Material Fee or a $10.00 Material Fee for students who already have material, is due
August 1st, 2010. After August 1st add an additional $7.00 to material costs for shipping. Classes are Tuesday
and Wednesday:9:45-10:40 A.M. or 11:00-11:55 P.M.and Thursday 9:45-10:40 A.M. Tuition is $80.00 for the
semester or $25.00 monthly for 4 months. Parents are required to attend this class with their child. No
additional children may attend class. Your paid child needs your undivided attention when in class. Babes in
carriers or extenuating circumstances will be taken into consideration. Class size limited to 10.

IMAGINE THAT: a $70.00 or $75.00 Material Fee or a $10.00 Material Fee for students who already have
material, is due August 1st, 2010. After August 1st add an additional $7.00 to material costs for shipping.
Classes are Monday at 9:45-10:45 A.M., or 1:00-2:00 P.M. or Tuesdays 1:00-2:00 P.M. Tuition is $85.00 for the
semester or $30.00 monthly for 4 months. Parents are required to attend the last 10 minutes of class for
sharing time. Class size limited to 12.

PLEASE ADVISE ME OF ANY MEDICAL CONDITIONS YOUR CHILD HAS, OR RESTRICTIONS OF ANY KIND.