Baby Sign-A-Long

REGISTRATION FORM

Child's Name:
Date of birth:	(00/00/0000)
Parent' Name:
Address:
Address 2:	(if applicable)
City:
State:
Zip Code:
Home Phone:	(000-000-0000)
Mobile Number:	(000-000-0000)
Email:
Additional Child's Name:	(if applicable / 50% per additional child)

Please register my child and me for Baby Sign-A-Long's ten week program

Location:
Days & Dates:
Time:

I agree to pay for the ten week program. Program fee includes parent pack and weekly handouts.

Total to be paid:

Total amount must be received at least one week prior to first class in order to hold a space in the program.
Please make checks payable to Baby Sign-A-Long, LLC. All payments are non-refundable. Please mail check to:

Baby Sign-A-Long, LLC
13778 Carters Grove Lane
Jacksonville, FL 32223

I, , parent/guardian of the above named child, give Baby Sign-A-Long, LLC permission to use photos and/or comments obtained from any of the classes for promotional purposes. I further agree to hold harmless Baby Sign-A-Long, LLC and its employees from liability in the event of ingury to me or my child.

Date:	(00/00/0000)
Parent/Legal Guardian:

Additional comments or questions: