| 2011 SUMMER SESSION SCHEDULE & REGISTRATION To Register Fill out registration form and mail payment to: Cindy Sugg 1821 Scenic Drive Maryville,Tn 37803 Make checks payable to: Cindy Sugg Child's Name:___________________________________________________ Age:_______________ Birthdate:__________________________________ Parent(s) Name:_________________________________________________ Adult attending with child - if not a parent:_____________________________ Address:_______________________________________________________ City:______________________________ Zip:_________________________ Phone (home):____________________ work or cell:____________________ E-Mail Address:_________________________________________________ How did you hear about Kindermusik?________________________________ PLEASE CIRCLE FIRST AND SECOND CHOICE (from above list) TOTAL DUE $___________ |