Renaissance Kids, Inc

Renaissance Kids, Inc. Cunneen-Hackett Arts Center 12 Vassar Street (“Theater Building”) Poughkeepsie, New York 12601 (845) 452 4225 www.renkids.org

Summer 2009 Registration Form

Child’s Name ______Date of Birth ______

Instrument your child plays (if applicable) ______Years Studied ______

Parents’ Names: Father: ______Mother:______

Home Address: ______City:______State:___Zip______

Phone: ______(home) ______(work) ______(cell/other)

email address: ______

Session Name(s) and Date(s): ______

______

Total Tuition: $145.00 per Session (Monday - Friday, 9:00 - 1:00 p.m) ______

Early Bird Discount (payment received by May 10, 2009) check here ___ and deduct $5.00 per Session ______

Current Renaissance Kids student discount* check here ___ and deduct $10.00 per Session ______

Extended Hours (1:00- 5:00 p.m.) add $135.00 per Session ______

Early Drop-off (8:00 a.m.) add $40.00 per Session ______

Total amount enclosed: ______

Please make all checks payable to Renaissance Kids, Inc. and send along with this completed form to Renaissance Kids, Inc., 12 Vassar Street, Poughkeepsie, New York 12601. Full refunds will be given should any session be cancelled due to lack of enrollment. No other refunds after June 15, 2009.

*This discount is for registered students of Renaissance Kids only. Registered students are students who have registered for one or more of our classes for which their yearly registration fee has already been paid and is still current as of the week of the Summer Session for which they are enrolling. Current private-lesson students may also take this discount. If your child’s yearly registration expires before the camp session, you may renew it in order to take the discount - the renewal is $20.00. Any questions, please call. Thank you!