KINDERMUSIK OF FARR WEST AND PIANO

SUSAN LARSEN/DIRECTOR PHONE: 782-8143

1576 Farr West Drive Farr West, Utah 84404

FALL REGISTRATION 2009

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

CHECK and CIRCLE THE CLASS YOUR CHILD WILL BE IN

___________KINDERMUSIK OUR TIME: ("WIGGLES AND GIGGLES") TUESDAY, 9:45
A.M.-10.40 A.M., and 11:00 A.M.-11:55 A.M., AND WEDNESDAY, 9:45 A.M.-10:40
A.M., and 11:00-11:55 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: ("SEE WHAT I SAW") MONDAY, 9:45 A.M.-

10:45 A.M., and 11:00 A.M.-12:00 P.M., AND TUESDAY 1:00-2:00 P.M. A $68.00
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, 2009, AND WILL END
THE WEEK OF December 13th, 2009. There will be a Thanksgiving break the week of November 23RD-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 student’s who already have material, is due
August 1st, 2009. After August 1st add an additional $7.00 to material costs for shipping. Classes are Tuesdays
at 9:45-10:40 A.M. or 11:00-11:55 P.M.,and Wednesdays 9:45-10:40, or 11:00-11:55 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 $68.00 or $75.00 Material Fee or a $10.00 Material Fee for student’s who already have
material, is due August 1st, 2009. After August 1st add an additional $7.00 to material costs for shipping.
Classes are Mondays at 9:45-10:45 A.M., and 11:00 A.M.-12:00 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.