Musikgarten Registration Form
Mail or bring payment to:
Papoose
82 Salem Tpk
Norwich, CT 06360
860-889-2323
How did you hear about us? _____________________________
Child’s Name____________________________________________________
Age(Years/Months)_______________________________________________
Birth Date______________________________________________________
Parent’s Name___________________________________________________
Address________________________________________________________
Telephone/Cell___________________________________________________
E-mail address___________________________________________________
Class__________________________________________________________
Day/Time/Location_______________________________________________
*One-time Enrollement fee is $10.00 for new students
*Family enrolling siblings may deduct $5.00 per child from the total cost.
*Returning students receive $10.00 off per child from the total cost.
*Active Papoose membership recieve 10%off tuition
*Refer a friend and get $5.00 off from the total cost
Friend’s Name_______________________________________________________
Registration fee +Tuition + Materials =
$
Discounts? =
$
Total =
$
Payment
C.Card________________________exp______
Check#_____________________
Online Payment __________
*Tuition is not refundable and must be paid before the first class*
*Family wanting to pay in 2 payments you must submit post dated check for the balance due or agrees to allow their credit card to be charged amount due mid semester.
I allow Papoose, LLC to charge my credit card for the remaining balance for a Musikgarten semester.
signature___________________________ Date:___________________________
c.c#_______________________________ exp____________________________
Office Use:
Amount paid______________ Date_____________ Check #____________ Balance Due_____________
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