Fall Registration 2008

To register please submit this registration form and follow the direction to pay with paypal.
Please Register each child individually.
Fall Fees 2008
Our Time
Members
$154
Non-Members
$166
Sibling Kits = $28

Child’s Name:
Age:
Parent’s Name:
Address:
City, State & Zip:
e-mail
Phone Number
EMHCHF Member: Yes No

Class: (select one)
Day & Time:

Amount to be charged $

To be completed by parent or legal guardian:
I accept full responsibility of my child for his/her use of any apparatus, appliances, facility privileges or service whatsoever, owned and operated by the EMH Center for Health & Fitness and Kindermusik with Nancy. I shall hold this center, its shareholders, directors, officers, employees, representatives agents, and Kindermusik with Nancy harmless for any and all loss claim, injury, damage, or liability sustained or incurred by my child resulting therefrom.

Parent/Legal Guardian Signature:
Date:

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Kindermusik with Nancy
440-785-3301
info@kindermusikwithnancy.biz

Classes are located at:
The EMH Center for Health & Fitness
1997 Healthway Dr.
Avon, OH 44011
(Driving Direction)