bartis' Creative Studio::featuring Kindermusik and Orff

ABC Music & Me Registration Form
To enroll, please complete form, print, then mail this registration form with your check made payable to:
Bartis' Creative Studio, 639 Scott Ave., GSO, NC 27403 or Fax: with credit card payment to 336-855-7062

Parent's Name(s):

Address:

City/Zip:

Home Phone:

Other Phone:

e-mail:

Please Check:

I agree to the Studio Policies.

New to program or previously enrolled

Emergency Contact:

Phone:

How did you hear about the program:

Child's Name:

Age/Birthday:

Tunes for Toddlers (18-24 months) $230
ABC Music & Me (2-4 years) $300 for 7 units
ABC Music & Me (4-6 years) $300 for 7 units

Total:

Payment Options

Pay in full for the year

Cardholder Name:

Credit Card Number:

vin #

last 3 digits on the white strip.

Exp. Date:

Billing Address:

City & Zip Code:

Because materials are not re-useable, I understand my responsibility for the cost of materials, once we are registered for a class. Additionally, I understand that I have made a commitment for my child to participate in the above class. Should we find that, after the class has begun, we are unable to keep this commitment, I understand that my tuition and fees are non-refundable.

* Signature
Please Sign

Date: