Baby Signs® with Gillian

Course Registration and Product Order Form

Please fill out the information in this form and submit.

* Parent's First Name:

* Parent's Last Name:

* Date:

Child's Name:

Child's age (months):

* Street Address:

Address Line 2:

* City:

* State:

* Zip Code:

* Phone Number:

* Email:

Please note: In order to reserve a place for you and your child, a 50% deposit is required within one week of registration. The remaining balance is due on the first day of class. If you have any questions, please call.

Please make your check (# ) payable to Gillian Dennis (Baby Signs® with Gillian)
and mail to: 1760 Goldentree Pl, Charlottesville, VA 22911

Registration:

	Baby Signs® Parent Workshop Enrollment (including Parent Kit) - $55.00
	Baby Signs® Parent Workshop Enrollment (excluding Parent Kit) - $25.00
	Sign, Say & Play® Enrollment (including SS&P Kit) - $125.00
	Sign, Say & Play® Enrollment (excluding SS&P Kit) - $75.00
	MORE Sign, Say and Play® Enrollment including MSS&P Kit) - $125.00
	MORE Sign, Say and Play® Enrollment (excluding MSS&P Kit) - $75.00
	Rumble. Tumble, Tummy Time! Enrollment - $10.00
	It's Potty Time! Enrollment - $10.00

* Please indicate preferred class start date here:

Products:

	Baby Signs® Complete Starter Kit - $39.95
	Sign, Say & Play® Starter Kit - $49.95
	MORE Sign, Say and Play® Kit - $69.99
	Baby Signs® Potty Training Kit - $39.95
	'Signs at a Glance' Flip Guide (English) - $12.99
	'Signs at a Glance' Flip Guide (Spanish) - $12.99
	Quick Reference Guide

1.5% VA sales tax only applies on products, and only if purchased without a course or workshop

1.5%

Course Cancellation Policy: No refunds will be given for cancellations made less than 48 hours before the begining of the Parent Workshop or Sign, Say & Play™ course. If the cancelling participant has ordered a Baby Signs^® Program product kit, they may claim it at anytime. Cancellations prior to 48 hours will receive a full refund.

Baby Signs^® Program Product Refund Policy: If, for any reason, you are not satisfied with your purchase you may return the product(s) within 30 days from the date of receipt for a full refund of the product price. Returned products must contain all of their original components and must be undamaged. You are responsible for return postage.

Gillian Dennis
Independent Certified Instructor
Baby Signs^® with Gillian
Gillian_at_babysignsprogram_dot_com

http://www.babysignsprogram.com/withgillian

(434) 296-2462 / (434) 409-8703

* Indicates Response Required