BOYS & GIRLS CLUB
CLASS REGISTRATION FORM
WINTER CLASSES: FEBRUARY 11 - MARCH 29

SPRING CLASSES: APRIL 8 - MAY 21
Fall session starts Oct. 21
PLEASE PRINT OUT

Student Name ____________________________________Grade___________________

Address (include zip) ______________________________________________________

Parent Name _________________________________day phone:___________________

Evening phone:___________ E-mail address (if applicable)________________________

Cost for each 7-class series is $150 for adults and $100 for children. Scholarships are available for low and moderate-income families with the support from Geraldine R. Dodge Foundation and Community Development Block Grant from the City of Jersey City.Some classes also require limited materials fee to be determined by teacher.

Enclosed is payment of ____$150 for adults, ___ $100 for children-regular registration,
or ____$5-scholarship registration. Scholarship applicants must complete income information on back of this form. Discounts available for siblings: $100 first child, $75 Second and $50 for third Child.

• Include payment with registration form by check or money to: Boys & Girls Club- Arts on the Hudson. Money will be refunded if classes are filled or canceled.

• On-Site registration at Boys & Girls Club: Weekdays 3:00-6:30pm, see Kecia at front desk.

• If you are interested in more than one class, number in order of preference (ie: #1 for first choice)

____ BUILD YOUR OWN WEB SITE 4th — 8th grade
MONDAYS 4:00 -5:30

____ GUITAR 1st — 8th grade
Individual 20-minute lessons
MONDAYS & TUESDAYS 3:00 — 6:00

____ DANCE FOR LITTLE FEET K-2nd grade
MONDAYS 3:15 — 4:15

____ DANCE RHYTHMS 3rd - grade and up
MONDAYS 4:30 -5:30

____ CREATIVE DRAMA M 2nd- grade and up
TUESDAYS 2nd — 4th grade: 4:00 — 5:00
5th — 8th grade: 5:00 — 6:00

_____ FUNDAMENTALS OF SELF-DEFENSE
WEDNESDAYS 3rd — 6th grade: 3:30 — 4:30
7th grade and up: 4:30 — 5:30

_____ PIANO 1st — 8th grade
Individual 30 -minute lessons
WEDNESDAYS & THURSDAYS 3:00 — 6:00

_____ VIOLIN & VIOLA 2nd — 8th grade
Individual 30 -minute lessons
FRIDAYS 3:00 — 6:00
Letter M symbolizes Master class