Birthdate/dates

In the chart below use the following time codes in the boxes representing the days chosen:  9-12 . 9-1 . 9-3 . 9-5

Fees Per Day

Monroe Street Movement Space

Registration Form-Summer Arts Camp—2009 –Starts 3/1/09

Student Age/ages

City/ State/ Zip Code

Work Phone/Cell

Work Phone/Cell

I have read the terms of this registration, understand and agree to its conditions.

720 Monroe Street, C-504, 5th floor   Hoboken, New Jersey   07030

201-222-8033   E-mail: info@movementspace.com   Website: www.movementspace.com

To register, fill out the form, sign at bottom and send in. Your signature is required to complete this registration.

REGISTRATION WILL NOT BE PROCESSED WITHOUT THE FOLLOWING:

· Copy of birth certificate for Children ages 3 to 5 years.
Copy of Immunization records for all students.
Signed Registration Form
Non-refundable $20. Registration Fee and 1/3 Total Tuition.

The remaining tuition is due on your child’s first day of attendance. Deposit will be refunded minus a $35. processing fee, if you withdraw two weeks prior to your first day of attendance.
After the program starts there will be no refunds, make-ups or credits for missed classes.      

Please Note: All children must be toilet trained and able to care for self in the bathroom.

You may enroll in all or parts of the program: any combination of days.
Ages 3-4 years:  9-12noon or 9-1pm         Ages 5-12 years:  9-12noon, 9-1, 9-3, or 9-5

Early Drop-off is $5.00 per use and Late Pick-up is $10.00 per use.

Siblings

20.00

25.00

40.00

55.00

Times

9-12

9-1

9-3

9-5

Fees per child

25.00

30.00

45.00

60.00

METHOD OF PAYMENT

Tuition Total______________

*1/3 Deposit_______________

*Registration Fee      $20.00

1/3 Dep. & Reg. Fee__________

Balance Due 1st Day __________