Children Program Registration

Mail Payment To:
The Etiquette Factory by Miss Kim LLC
Class Name: Perfectly Polite Dining Etiquette - Nordstroms Beachwood
Number of Classes: 1
Instructor: Kimberlee
Class Beginning Date: Jan 21, 2023
Class End Date: Jan 21, 2023
CLass Time: 11:00-1:00
Recommended Age: 8-15
Location of Class: Nordstrom's Beachwood
26200 Cedar Rd
Beachwood, OH 44122

Student Information

Child's Name
Gender
Male
Female
Age
Emergency Contact Phone
Any food allergies or religious or cultural food, personality/ developmental concerns? My indicating your concerns we can the accommodate you needs.

Parent Information/Guardian

Name
Email
Daytime Phone
Evening Phone
Payment Information (select one)
I will be mailing a check along with the registration form
I would like an invoice emailed to me