Kindermusik With Shannon: Registration Form

Kindermusik With Shannon
Registration Form

Please Select a class:

	Village Wednesday's from 09:15 to 10:00AM
	Our Time Wednesday's from 10:05 to 10:50AM
	Family Time Monday's from 01:00 to 01:45PM

Last Name

Child's First Name

Parent's First Name

Child's D.O.B

Address

City

Province

Postal Code

Home Telephone

Work Telephone

Email Address

Work Telephone

Does your child have any special needs?
(allergies, developmental delays, etc...)

Additional Comments

To register for a Kindermusik class, please complete and mail the form to:

Shannon Eddy-Smith

40 Stillwater Drive,

Ottawa, ON

K2H 5K2

You will be contacted within 2 business days, to confirm your registration in the class.

If you are registering for a class after it has already started, your tuition fees will be adjusted accordingly.

If you prefer, you can print the registration form and mail it to:

NOTE: To reserve your child's spot in the requested class, the deposit is required no later than 1 week prior to the first class.