Registration

After completing this form, you will be redirected to our secure shop for payment.

Required fields are marked with an asterisk (*).

Child 1 Name *
Child 1 Name
Child 2 Name
Child 2 Name
Child 3 Name
Child 3 Name
Child 4 Name
Child 4 Name
Address *
Address
Parent 1 Name *
Parent 1 Name
Parent 2 Name
Parent 2 Name
Home Phone *
Home Phone
Work Phone
Work Phone
Cell Phone
Cell Phone
Health Concerns? *
Parent Helper?
Photo Permission? *
Parent Permission *
I hereby give permission for my child to participate in the above class. While all reasonable precautions will be taken to assure my child’s safety and to prevent any injuries from occurring, I will not hold the instructor or the PTA and its officers and members liable for any accident, which may occur. My child and I understand that if, after one warning, any student is: a) unable to maintain appropriate behavior in class; or, b) not picked up promptly after class that student will not be allowed to attend the remaining sessions scheduled for that class. I understand that parents will be notified at the time of the warning and before a child is removed from class. Refunds will not be issued for any student so removed. In addition, I grant permission for the instructor and/or PTA officials to obtain emergency medical care (by calling 911) for my child if it appears necessary. We do not offer refunds for tuition paid once a session has begun, but will provide a credit towards future Murray Educational Services programs when warranted.