Student's name *
Student's name
Families with siblings: Please register each child separately. 10% discount will be applied to both sibling(s). Please type "sibling" in optional note column at bottom of form.
Parent's Name *
Parent's Name
Parent's Phone *
Parent's Phone
Student's Date of Birth *
Student's Date of Birth
Registering for *
Please check one or multiple boxes:
Please bill me for *
If choosing both Tues/Fri options in same offering for same child, fee will be doubled and 10% discount will be applied at billing. Fees listed apply to Winter 2018 (9 sessions) and are valid if registered and paid by Dec. 1. One make-up sessions per season can be taken during same offering on different day, if available.
Please note any questions about registration, or if known, if there will be dates your child will miss.

MBVW will send billing invoice or confirmation to your email address within 48 hours. Payment options will be offered through PayPal or by cash, check or credit card in person prior to first class.  If you do not receive email confirmation from us within 48 hours, please email marciabrooksct@gmail.com to confirm registration or contact us with any questions regarding class placement or for further info.