Top of FormPlease
fill out form, print, sign at the bottom and bring along
to first class
name
(first and last)
Parents names
Age
Phone number:
-
Emergency phone:
-
Mom's cell phone:
-
Dad's cell phone:
-
Address:
e-mail address:
Important
information about your child you think I should be aware of
(ADD, allergies
etc________________________________________________________________________________________________________________________________________________________________________________________________________________________
Check the desired class/s:
Kids:
Thursday 4:15-5:00 age 3.5-4.5
Thursday
5:20-6:05 age 4-6
Tuesday 4:15 - 5:15 age
6-8
Tuesday 5:30 - 6:30 age 8-10
Monday
4:00-5:15 age 10-12
Monday
5:30-6:45 age 11-13
Important! please read the
following info regarding tuition and class policy:
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Payment is calculated by the number of
classes in each month. Payment schedule will be handed out
and posted in the studio.
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Payment is due on the first class of every month. If not made before the
second class starts, a $5 late fee should be added.
-
There will be no refund for absences, unless notification is made two
weeks in advance. Make up class is possible, based
on space and age appropriate.
Tuition for Kal VaChomer (Tuesday
4:15-5:15) class is $16 per class.
Tuition for Kaftor VaPerach (Monday
5:00-6:15) class is $18 per class.
Tuition for Blue Paintbrush (Tuesday
5:30-6:30) class is $16 per class.
Tuition for Dimyon Hofshi (Thursday
4:15-5:00) class is $15 per class
Please sign and bring along with your first payment
 I
_____________________Parent of ____________read, understood
and agree to all terms above.
OR SEND TO THE ADRESS BELOW
Taly Shemy
1250 Klee Ct.
Sunnyvale,
CA. 94087
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