Summer 2011 Registration
Parents Names
Home Address
Where did you hear about us?
Is this your first session?
For continuing students only:
Has any of your information changed?
Which class are you registering for session 1?
What day & time?
Do you already have materials for this class?
Which class are you registering for session 2?
What day & time?
Do you already have materials for this class?
Which class are you registering for session 3?
What day & time?
Do you already have materials for this class?
Students Name
Birthdate
Home Phone
Cell Phone
Work Phone
Email address
Does your child have any allergies?
Does your child have any developmental
delays or special needs we should be aware of?
Is there anything else you would like us to know?
There is a $15.00 charge on all returned checks and a $20.00 cancellation fee. There is a $10.00 registration fee after April 10. The registration fee is non-refundable. There are no cancellations/refunds after April 15. While we make every effort to provide a child safe environment, you are responsible for supervising your child while on the premises or in a class together. SCCM and it’s agents are not liable for accident or injury on or near the premises. On occasion we take photographs in class to use for educational or promotional purposes. Your registration confers consent of all aforementioned policies.
Do you verify that you have read and accept such policies?
You can register one student for up to 3 classes on this form. Fees include tuition & materials. If you already own the materials they will be deducted from your total
