Mail-in Registration – Kindermusik with Carla

Registration Form Spring 2024

On-line is your fastest option for securing a spot in class.

To enroll, please complete, print, then mail this registration form
with your check made payable to:
Kindermusik with Carla, 250 E Philadelphia Ave, Bridgeport, WV 26330

Parent/Guardian:

Mailing Address:

City:

State:

Zip:

Home:

Cell Phone:

Email:

New to Program

Previously Enrolled

How have you heard about us?

1st Child's Name:

Date of Birth

Program:

Day/Time Preferred:

2nd Child's Name:

Date of Birth

Program

Day/Time (1st Choice):

Day/Time (2nd Choice):

Payment Plans

Payment in full

Payment Method

Check (payable to Kindermusik with Carla)

Credit Card: Visa or MasterCar

Cardholder Name:

Credit Card Number:

Exp. Date:

3 Digit Code:

Billing Address:

Billing State;

Billing Zip:

I am enrolling my child for the entire semester of Kindermusik and understand that my
non-refundable payment(s) is due accordingly.

Signed:

Date:


Spring 2024
January 29 to May 3
Courtesy Information
Village (Level 1)
Total Classes	13
Class Length	40 minutes
Total Cost	$224
Includes tuition and materials
Adult in attendence
Our Time (Level 2)
Total Classes	13
Class Length	40 minutes
Total Cost	$224
Includes tuition and materials
Adult in attendence
Imagine That! (Level 3)
Total Classes	13
Class Length	40 minutes
Total Cost	$224
Includes tuition and materials
Summer Adventures
Totals Classes 4
Class Length	40-45 minutes
Total Cost $75	$75
Includes tuition and materials