Summer Day Camp Upper Valley TaVaci School of Performing Arts

July 14th REGISTRATION FORM

July 27th
Fall 2011/Spring 2012

Student Name: ________________________________________ Age: _______________ DOB: ________________

One form per student

Parents’ Name: ____________________________________________________________________________________

Mailing Address: ___________________________________________________________________________________

Phone Number: ___________________________________ Cell Number: _____________________________________

E-Mail Address: _______________________________________

Emergency Contact Name and Number: _______________________________________________________________

School Attending: __________________________________________________ Grade:__________________________

Please tell us about your child (Special needs, food allergies, personality, etc.) ________________________________

__________________________________________________________________________________________________

Our main mode of contact will be through e-mail and text message. Do you check either on a regular/daily basis?

Yes No If no, what is the best way to contact you? _______________________________________________

Registration Fees: Non-refundable

Which session do you prefer?
$25.00 1st student, $10.00 each additional student
All Classes will be held on Mondays
Yearly Tuition:
Ages 4-6 4:15-5:00
$297 1st student
Ages 6-8 5:15-6:00
$252 2nd student
Ages 8-10 4:00-4:55
$207 for 3rd and additional students
Ages 10-12 5:05-6:00
All class ages/sessions are flexible according to the needs of the child and family.
All requests will be considered and we will do our best to accommodate them. For your convenience we accept monthly payments due at the first
lesson of the month. $5 will be automatically applied to late payments.
All returned checks will be charged a $20 fee.

$33 1st student

$28 2nd student
$23 3rd and additional students
***Please mail registration forms and registration fees to: Lisa-Marie Jensen 103 North 1800 East Rexburg, ID 83440***

ALL REGISTRATION FORMS AND FEES RECEIVED BEFORE MAY 31st WILL BE ENTERED INTO A
DRAWING FOR A TUITION FREE SEMESTER OF TAVACI!
Winner will be responsible for registration, concert, and costume fees.

rexburgtavacigroup.blogpost.com *** lisamarieandbrooke@gmail.com *** facebook TaVaci Upper Valley School of Performing Arts