Kidstunes Enrollment Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

ONLINE PAYMENTS MUST BE MADE AT WWW.KIDSTUNES.ORG UPON SUBMITTING ENROLLMENT FORM.

I would like to enroll my child in weekly classes at my child's school *

(select your child's school from the list):

Child's First Name *

Child's Last Name *

Date of Birth *

YYYY

Starting Date - Please enroll at least 24 hours prior to start date *

Note: If you would like your child to begin classes mid-month, your tuition will be prorated.

YYYY

Parent (s) First Name *

Parent (s) Last Name *

Phone Number *

E-mail Address *

Kidstunes will never share your e-mail or personal information with anyone or entity outside of Kidstunes.

Street Address *

City, State *

Zip Code *

May we take your child's picture during class for future publications? *

Yes

Tuition Rates *

Regular tuition - $42.00/month

Staff Tuition - $36.00/month

Military Tuition - $36.00/month

Siblings - $36.00/month per child

Other:

One-Time Registration Fee *

$10.00

Required

Coupon Code (one per enrollment)

Referred by (child's name) - optional

(must be a currently enrolled student)

Payment Method *

I will pay online at www.kidstunes.org

I will mail a check to 717 Chapel Hill Road, Burlington, NC 27215

I would like to enroll in Recurring Payments (a form will be e-mailed to you)

Terms of Enrollment *

Please select each box to agree to the terms of enrollment

I give Kidstunes permission to take my child to music class each week at this center

I understand payments are due by the 10th of each month and a $5.00 late fee will be charged if payment is received after this date. There is no credit for missed classes or school closings.

I agree to provide a two-week written notice if I wish to discontinue my child from this program.

Required

Comments

Signature *

(please type your name here to confirm enrollment)

Submit Form *

I am done

I would like to enroll another child

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms