KINDERMUSIK OF FARR WEST AND PIANO

SUSAN LARSEN/DIRECTOR PHONE: 782-8143

1576 Farr West Drive Farr West, Utah 84404

SPRING REGISTRATION 2011

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

CHECK and CIRCLE THE CLASS YOUR CHILD WILL BE IN

___________KINDERMUSIK OUR TIME: ("FIDDLE-DEE-DEE”)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. A $60.00 Material fee, or a $10.00 Material fee for children already owning
material is due the 20th of December. This fee will be a deposit for holding your child's place in
this class. Material fees received after December 20th, add an additional $7.00 for shipping.
Tuition will be $85.00 each semester or $25.00 a month for January, February, March and
April. THIS CLASS IS FOR CHILDREN 18 Months to 3 years of age. Parents are required to
attend.

_________KINDERMUSIK IMAGINE THAT: ("CITIES")MONDAY 9:45-10:45 A.M.,

MONDAY 1:00-2:00 P.M., and TUESDAY 1:00-2:00 P.M. A $65.00 Material fee for
continuing students, a $70.00 Material fee for new students (which includes a backpack), or a
$10.00 Material fee for children already owning material is due the 14th of December. This fee
will be a deposit for holding your child's place in this class. Material fees received after
December 20th, add an additional $7.00 for shipping. Tuition will be $90.00 each semester or
$30.00 a month for January, February, March and April. 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 January 3rd, 2011
AND WILL END THE WEEK OF April 18th, 2011. IF PAYING TUITION MONTHLY IT WILL BE DUE BY THE
10TH OF EACH MONTH, A $15.00 LATE CHARGE WILL BE ASSESSED. THERE WILL BE NO CLASSES THE WEEK
OF JANUARY 24,2011.
.
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 December 20th, 2010. After December 20th, 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 A.M., or Wednesdays 9:45-10:40 or 11:00-11:55
A.M. Tuition is $85.00 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 $65.00 or $70.00 Material Fee or a $10.00 Material Fee for student’s who already
have material, is due December 20th, 2010. After December 20th, add an additional $7.00 to material
costs for shipping. Classes are Monday 9:45-10:45 a.m. or 1:00-2:00 p.m..Tuesdays 1:00-2:00 p.m.
Tuition is $90.00 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.