Kinderdance® Manhattan and The Bronx
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Registration Form
PLEASE NOTE: Current classes on offer are for 15 -23 month olds (Kinderdance With Me) and 2 Year Olds (Kindertots)
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Indicates required field
Parent's Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Primary Email
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Secondary Email
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Phone Number
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Child's Name (Please note: If registering more than one child you will need to fill out a separate registration form for each child)
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First
Last
School Name
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Classroom name (example: Toddlers, PK3, Home
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Gender
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Female
Male
Select Program
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Monday Kindertots 9:00
Monday Kinderdance With Me 9:30
Emergency Contact
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First
Last
Emergency Phone Number
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I have read and agree to all policies, terms and conditions, as outlined in the Policies page of the Kinderdance® Manhattan and the Bronx website.
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Yes
Click here for Policies Page
I realize that any program such as Kinderdance® and its affiliated programs which involve movement and motion can result in physical injury. I permit my child to participate in Kinderdance® and release Kinderdance® International or local Kinderdance® franchisees from all liability for injury to my child from his/her participation in this program. Furthermore I agree to allow Kinderdance® International or local Kinderdance® franchisees to use photographs and/or video of my child for Kinderdance® web-sites and promotional purposes without compensation to my child or myself. I have read and agree to this liability waiver.
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Yes
Payment
First semester Kinderdance With Me and Kindertots classes at Habonim start on Nov 7, 2016 and cost $170 for 11 classes
Parents can pay two ways:
1. Mail a check made out to Kinderdance and send with a printed registration form to:
Kinderdance
645 West End Ave #1F
New York, NY 10025
2. Pay online via Chase Quickpay.
You do NOT need to have an account with Chase to use this service
My recipient email is KinderdanceNYC@aol.com
Totally safe, neither of us will see any account information.
Click here to enroll in Chase Quickpay
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Home
ABOUT US
Programs
Register
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FAQS
contact