Student Information							Registration Form
Child’s Name:............................................................................................................................................
Date of Birth:..........................
Names and ages of siblings:....................................................................................................................
Names of Parent/guardians:...................................................................................................................
Home phone: .....................................			     Mobile phone: ......................................
Address: .....................................................................................................................................................
Suburb: .......................................................		 		Postcode: ........................................

What musical tuition has the child had, if any?:....................................................................................
List any medical or behavioural problems of which the Lady Bug Musik teacher should be aware: ......................................................................................................................................................................
How did you find out about Lady Bug Musik?..........................................................................................

CIRCLE ONE:								Class times:	Monday		Friday

9:15am	Family Time			Family Time

10:15 am	Preschooler class	Preschooler class
	
11:15 am     Toddler class		Toddler class

12 pm	Baby class		Baby class

		Age Groups: 
		Baby class 0 - 18 months old			
		Todder class: 18mths - 3 years old
		Prescholers class: 3 - 5 years old	
		Family Time: 0 - 5 years ols