Class Registration Form
Class information:
Name of class___________________________________________
Day of week_______________________Time of day____________
Teacher's name_________________________________________
Student's information:
Student's name__________________________________________
Date of Birth_______________________Grade________________
Parent's names__________________________________________
Street address__________________________________________
City______________________________Zip___________________
Email address___________________________________________
Home Phone____________________________________________
Emergency contact_______________________________________
Tuition payments are due the first day of the month through December (1st semester), or May (2nd semester).
Upon enrolling and attending classes, you are financially responsible for that semester’s tuition. All fees are non-
refundable unless the class is cancelled. Make checks payable to the teacher. Please mail or give registration
checks to your teacher along with this registration form.
The membership fee for Dunwoody Classes for 2010-2011 will be $40 per semester for one student or $60 per
semester for multiple students enrolled, which includes unlimited class choices. The membership fee is
made payable to Becky Humphrey and must be paid before or by the first day of class.
The facility fee for each family this year is $40 for the entire school year. A separate check needs to be made
out to North Peachtree Baptist Church in the amount of $40 and sent or delivered to Becky Humphrey on or
before the first day of classes.
Users of Study Hall for 2010 - 2011 school year will be charged $10 per student, per semester, made payable to
Becky Humphrey at the beginning of each semester.
Teacher registration and tuition are made payable separately to the individual teachers.
Mailing address:
Becky Humphrey
2678 Camelot Ct.
Duluth, Ga. 30096
Signature________________________________Date________