The International School AFTER-SCHOOL SPORTS PROGRAMS: 28555 Middlebelt Rd. Farmington Hills, MI 48334 USA www.theinternationalschool.org, Phone: 248-851-7372 Please call 248-207-3732 REGISTRATION FORM FOR TABLE TENNIS CLASSES January 6 through June 11, 2015 Name of Child: _______________________________________________________ Age: ___________ Name of Child: _______________________________________________________ Age: ___________ Name of Parent: ______________________________________________________ Date: ___________ Address: __________________________________________________ City: ______________________ Zip Code: _________ Home Phone: ________________________ Cell: _______________________ PLEASE CHECK CLASSES BELOW: DAYS AND TIMES: FEE FOR EACH CHILD (Ages 5 to 18): Tuesday 4:45pm – 6:45pm One class per week: Thursday 4:45pm – 6:45pm Two classes per week: $1,010 ** $525 * * Payment for one class can be split into two payments: $300 due 1/6/2015, $225 due 3/3/15. ** Payment for 2 classes can be split into three payments: $400 due 1/6/2015, $350 due 3/3/15, $260 due 4/2/15. Individual Classes if Begin at Later Date: $26.00 Each Class. (Note: No Classes February 17 & 19, and April 7 & 9 – May have Table Tennis Camp those weeks!) Checks payable to: The International School. Bring cash or check, with form to school office or to coach. Refunds may be made if written request is received prior to class. The International School reserves the right to cancel a class due to insufficient enrollment. COACHES: David Kleshchik (Former Table Tennis Champion of the Ukraine), and Tamaki Murakami (2011 & 2012 Michigan Woman Champion) Date:______ Received Check#_____ or Cash Amount Paid: $_______ Balance Due: $________ TABLE TENNIS CLUB FOR ADULTS: FEE: $6.00 per session Tuesday & Thursday: 7:00pm – 10:00pm Visit website: www.FHTTC.com, or call Saturday & Sunday: 12:00pm – 4:00pm Coach David Kleshchik, Phone: 248-207-3732