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Kindermusik with Cath Smithson in York

Registration Form

NAME OF CHILD  
DATE OF BIRTH  
PARENT/GUARDIAN'S NAME  
ADDRESS  
POSTAL CODE  
HOME TELEPHONE  
MOBILE TELEPHONE  
E-MAIL  
DAY OF FIRST CLASS  
TIME OF CLASS  
Preferred Day/Time for future consideration Mon am/pm Tues am/pm Wed am/pm Thurs am/pm Fri am/pm Sat am/pm

Health concerns/medical conditions/other comments:
...................................................................................................................................... ......................................................................................................................................

How did you hear about Kindermusik?
...................................................................................................................................... ......................................................................................................................................

I wish to enrol my child _____________________________into Kindermusik® Cuddle & Bounce/ Sing & Play / Wiggle & Grow/ Laugh & Learn / Young Child/Family Time (delete as appropriate) classes at ____________________________________, York.


SIGNED __________________________________DATE___________
(All personal records are strictly confidential)


Please make cheques payable to 'Cath Smithson' and return together with this completed form to: 28 Trentholme Drive, York, YO24 1EN