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To Register for Infant Sign Language classes, complete the online form below OR call 515-457-8834. If paying via check, mail to: Songs and Signs, LLC, 1020 Cedar Circle, West Des Moines, IA 50266.

Important Details:

1. Full payment is due within 5 days of your registration in order to secure your child's place in class.

2. We will make every effort to accommodate your first choice but this is not guaranteed. Please choose at least two choices (if possible). We will contact you if we cannot place you in any of your choices.

3. Please note that even if a class is not indicated as being full on our website at the time of your submitting this form, there may not be room in it by the time your payment is received. This is why it is important to include a 2nd choice (if possible) when registering.

4. We invite you to call if you have any questions about our classes prior to submitting this form.

(515) 457-8834.

* = Required Field

Mother First and Last Name: *

Father First and Last Name

Address: *

City: *

State: *

Zip: *

Home or Best Phone: *

E-mail: *

We will be sending our class confirmations by e-mail. Please make sure that mail from Songs and Signs or Bloynachan@gmail.com is on your email "safe list" and delivered to your inbox. If this poses a problem for you, please let us know in the "Other Pertinent Information" box below.

Child(ren)'s Names: Child 1 *

Child 2

Child 3

Date(s) of Birth: Child 1 *

Child 2

Child 3

6 Week Session, June 17 - July 22, 2014 (6:00 PM), in EITHER Clive OR Urbandale (location will be confirmed prior to first week)

Teacher: Denise Schmitz

1st Choice Class:* 2nd Choice Class:*

Other Pertinent information (ie: Are you registering with others, and if so, whom? Are there any special health issues or handicap accessibility and/or accomodations about which we should be informed?

If you are new to Songs and Signs and one of your friends referred you, please put their name here:

Cost:

$95.00

Method of Payment (Select One):

*Please tell us how you heard about us. (Select all that apply):

Please read the following and indicate your agreement by checking the "Yes" box:

I agree to assume responsibility for my child or children and myself and/or caregiver when upon the premises of a church or other location for a class with Songs and Signs, LLC., and will hold harmless Songs and Signs, LLC and any of its employees and/or agents in the event of any personal injury, property damage or loss, indemnifying said parties of any loss that I might incur as a result.

* I have read and understand the above policy:

A $15 cancellation fee will apply. No refunds after the first day of classes.

If you wish to pay by check, please call

If you are registering now and wish to pay online now, click

If you wish to erase your registration, click