Tutor Time Registration

Registration Form

* Indicates required field

Parent's Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Primary Email *

Secondary Email *

Phone Number *

Child's Name (Please note: If registering more than one child you will need to fill out a separate registration form for each child) *

First

Last

School Name *

Classroom name (example: PK4, PK3, Kindergarten) *

Gender *

Female Male

Select Program *

Kinderdance with Me 13-24 months Kindertots 2 years old (not available in summer) Kinderdance 3-5 years old (not in summer)

Emergency Contact *

First

Last

Emergency Phone Number *

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. Click here to open Policies *

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. *

Yes

Payment

Fall/winter session of classes at Tutor Time start on September 22, 2017 and costs $300 for 20 classes

Parents can pay four 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

3. Pay online through Venmo. Look up Carol Baird, profile picture is Kinderdance logo

4. Pay through Paypal

Class

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