Online Registration for Kindermusik of Clayton

This form registers you for the class(es) you choose. Please fill in first and second choice. All information will be kept private and not shared with any other individual, institution, or business. If you would like to hold your registration you may pay a non-refundable $10.00 deposit via mailed check. Deadlines for Registration Fee and Materials Fee payments are two weeks prior to the beginning of the class desired. Early bird registration will waive your registration fee. Check parent information page for Early Bird Dates. Your registration is not complete until these fees are paid. Please note there is a payment plan for your convenience. Just request it :) You will receive an email invoice within 24 hours or you may go to the Buy it Now button on the Curricula page. If you have not received your invoice within 24 hours please call me at 359-3473.

Parent Information

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Child One Information

First Name
Last Name
Date of Birth
Sex Male Female

Desired Class/Day/Time Child One

Product Name

Alternate Class/Day/Time Child One

Product Name

Child Two Information

First Name
Last Name
Date of Birth
Sex Male Female

Desired Class/Day/Time Child Two

Product Name

Alternate Class/Day/Time Child Two

Product Name

Enter the name and phone number of your emergency contact


How did you hear about us?

friend who attends class  newspaper             internet                information             
flyer or brochure         other

Would you like a payment plan?

payment plan

Today I will pay ...

Annual Family Registration Fee
Materials Fee
Tuition Fee
1st tuition payment

Method of Payment   


Electronic Signature verifies you agree to authorize all charges for Kindermusik Registration, Materials and Tuition. Type in your name as it appears on your drivers license.


email address to send your confirmation

An email invoice will be sent to you within 24 hours. Please click the submit button to complete your registration form and keep a copy for your file.

Reminder: $10.00 will hold your registration until two weeks prior the class(es) your child is signed up for begin. Registration is not completed until minimum amount is received from invoice. Remember please print your confirmation page and keep for your records.


Author information goes here.
Copyright © 2003 [Julie Stewart]. All rights reserved.
Revised: 06/08/08