Kindermusik by Catherine

Registration Form

Child's Name:*

M F

Date of Birth:*

(DD/MM/YY)

Parent's Name:*

Email:*

Address:

Home:

Work:

Mobile: *

Fax:

How did you hear about Kindermusik By Catherine?*

Please list any special needs or information that we need to know about your child*

Course:

Village (0 - 1.5 years)

Our Time (1.5 - 3 years)

Imagine That! (3 - 4 years)

Young Child (4 - 7 years)

Family Time (0 - 7 years)

Keyboard

music & more (2 - 4 years)

Story Time (2 - 4 years)

Play & Paints (6 - 18 months)

Play & Paints (1.5 - 3 years)

Messy Monster (0.5 - 1.5 years)

go Global (3-5 yrs / 5-7 yrs)

music Makers (3-5 yrs / 5-7 yrs)

Pre-Letterland (2.5 + years)

Early Years Letterland (3+ years)

* I have read and agreed to the course policies.

Security Code:*

Fields with * must be filled