Kindermusik with Debbie Elwood
Enrollment Form--Spring 2012

Child #1
Child #2
Child #3
Mother's name
Father's name

Mailing Address

Home phone #
Cell phone #
Work phone #

email address


How did you hear about Kindermusik?
Does your child have any special needs that the teacher should be aware of?
If "friend" or "other" please explain.
All classes require an $80 deposit with enrollment (non-refundable.)  Deposit is included in total amount due. Remainder is due at first class unless payment arrangements are made. Cost includes home materials and tuition.  I release any and all rights and claims for damages against Kindermusik with Debbie Elwood in the unlikely event of injury sustained by myself or my child as a result of this musical activity.
By submitting this form, you agree to the conditions in the above blue box.
Select class(es) below. This schedule is for Spring 2012. Classes begin the week of January 16, 2012.
DOB
DOB
DOB
Vill Mon 6:00pm
Vill Friday 9:00am
OT Monday 7:00
OT Tues 10:30
IT Tues 11:30
IT Tues 6:00
IT Fri 11:00
YC4 Tues 4:00
FT Friday 10:00