Clone of Fall 2 Registration 2025

Winter Session Registration

January 9 - February 27, 2026
Parent/Guardian Info
Name*

First NameLast Name
E-mail*
example@example.com
Relationship to Child*
Primary Phone*
(XXX) XXX-XXXX
Secondary Phone
(XXX) XXX-XXXX
Child 1 Info
Child's Name*

First NameLast Name
Child's Age*
Age in months or years
Class Selection*

Fridays @ 9:30am (ages birth-18 months)Fridays @ 10:30am (ages 18 months-3 years)Saturdays @ 10:30am Mini Session (ages 0-5 years) CLASS FULL-WAITLIST ONLY
Child 2 Info
Child's Name

First NameLast Name
Child's Age
Age in months or years
Class Selection

Fridays @ 9:30am (ages birth-18 months)Fridays @ 10:30am (ages 18 months-3 years)Saturdays @ 10:30am Mini Session (ages 0-5years) CLASS FULL- WAITLIST ONLY
Emergency Contact
Emergency Contact*

First NameLast Name
Emergency Contact Phone*
Please enter a valid phone number.
How did you hear about us?*

Search EngineSocial MediaFriend/FamilyFlyer/SignPrimeWise NewsletterFt. Thomas MOMS newsletterWise Owl PreschoolOther
Name of Person Who Referred You (So we may thank them!)

First NameLast Name
Terms and Conditions
Today's Date

MonthDayYear
_{By checking 'I Agree' below and submitting this form, you, the Parent or Guardian of the above student(s), agree to hold harmless Melodies to Grow On, including instructors and assistants from liability for any and all injuries which may occur during any class activity.}
please select*

I Agree
_{I give permission for the public display, including on social media and marketing materials, of any visual images that my child may appear in.}
please select*

I AgreeI Do Not Agree
Please verify that you are human*
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Classes held at St. Andrew's Church, Ft. Thomas, KY. Please bring payment of cash, check, or card to first class.
Should be Empty:

Winter Session Registration

Parent/Guardian Info

Child 1 Info

Child 2 Info

Emergency Contact

Terms and Conditions