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Birthdate/dates |


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Monroe Street Movement Space |
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Registration Form-Children’s Summer Karate |
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Student Age/ages |
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City/ State/ Zip Code |
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Print Name on Credit Card |
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Work Phone/Cell |
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Work Phone/Cell |
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I have read the terms of this registration, understand and agree to its conditions. |
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Class Fees $ 104.00 |
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720 Monroe Street, C-504, 5th floor Hoboken, New Jersey 07030 201-222-8033 E-mail: info@movementspace.com Website: www.movementspace.com |
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To register, fill out the form, sign at bottom Your signature is required to complete this registration. |
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METHOD OF PAYMENT |
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Tuesdays Registration begins 3/1/08
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4:30-5:00pm 3-4 year olds 5:00-6:00pm 5 years & older |