All About Hip Hop! (Kindergarten, 1st, & 2nd grades)

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Questions? E-mail Mrs. T. at hiphoptelestai@gmail.com

Child's Name *

Grade Level *

1st

2nd

Required

Adult 1 Name *

Adult 1 E-mail *

Adult 1 Phone *

Adult 2 Name

Adult 2 E-mail

Adult 2 Phone

Any health or learning notes for Mrs. T.? (asthma, diabetes, allergies, ADHD, autism spectrum, etc.)

I acknowledge that this class carries a certain amount of risk, as would any movement activity. In the event that my child should be injured, I assume all responsibility and will not hold Kerith Telestai liable. *

Agree

I give my permission for my child to be photographed/recorded without his/her name attached for the purposes of promoting this program. *

Yes

Your registration is not complete without payment. Tuition cost is $72. To pay, please write a check out to Kerith Telestai and leave it with either front office at Sage. Be sure to write your child's name and "Rising Stars" in the memo line. Unpaid registrations will be moved to a waitlist after 24 hours. Per Rising Stars policy, tuition payments are non-refundable.

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