In The Hills
Fall 2013
Class Registration Form
One Registration Form Per Student
One Registration Form Per Co-op
***Please Circle One***
Down The Valley - Naugatuck (Monday)
In The Hills - Torrington (Friday)
1. An initial, non-refundable deposit of
$20 per class must be made at the time of registration made payable to the class instructor. This amount will be applied to the cost of the class.
2. Class fees are also non-refundable.
3. Full payment for classes must be made in order to attend.
4. Changes made to registered classes will incur the loss of deposit for that class if made.
5. No email submissions. Only hard copies will be accepted.
6. A $20.00 Class Change Fee will apply, after registration is complete.
$20 per class must be made at the time of registration made payable to the class instructor. This amount will be applied to the cost of the class.
2. Class fees are also non-refundable.
3. Full payment for classes must be made in order to attend.
4. Changes made to registered classes will incur the loss of deposit for that class if made.
5. No email submissions. Only hard copies will be accepted.
6. A $20.00 Class Change Fee will apply, after registration is complete.
Co-op Location - Please Check One - ____________ Naugatuck on Monday
__________ Torrington on Friday
Parent's Name - Please Print (Include Last Name)___________________________________________________
Parent's Signature ______________________________________________________________________________
Cell Phone # ___________________________________________________________________________________
Home Phone # _________________________________________________________________________________
Email _________________________________________________________________________________________
Child's Name _______________________________________________________________Age_____________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
__________ Torrington on Friday
Parent's Name - Please Print (Include Last Name)___________________________________________________
Parent's Signature ______________________________________________________________________________
Cell Phone # ___________________________________________________________________________________
Home Phone # _________________________________________________________________________________
Email _________________________________________________________________________________________
Child's Name _______________________________________________________________Age_____________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________
Class Time_________________Name of Class_______________________________Teacher___________________