San Diego Children's Choir


Neighborhood CHOIR After School Program Registration Form

Singer's Name *
Singer's Name
Singer's Birthdate *
Singer's Birthdate
Singer Address *
Singer Address
Parent/Guardian Names
First (1) Parent/Guardian Name *
First (1) Parent/Guardian Name
Parent/Guardian Cell Phone *
Parent/Guardian Cell Phone
Second (2) Parent/Guardian Name
Second (2) Parent/Guardian Name
Parent/Guardian Cell Phone
Parent/Guardian Cell Phone
Emergency Contact Name (Not Parents/Guardians)
Person to be notified in an emergency if parents/guardians cannot be reached.
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Cell Phone
Emergency Contact Cell Phone
Demographic Information
This information is used for grant application purposes. Please check all that apply.
Release of all Claims, Medical or Otherwise, or Minor Child
Claims Release *
In consideration of permitting my child named above to participate in rehearsals, performances, and all other activities of the San Diego Children's Choir between September 1 and August 31, we, guardians of said minor, forever release, acquit and discharge the San Diego Children's Choir and its employees and representatives from any and all liability. The undersigned hereby agree(s) to indemnify and save harmless the above parties from all loss, damage, costs and expenses, by reason of any claim, demand or suit made on behalf of said minor child.
This form gives permission for the use of image, pictures and recordings of my child, listed above, by the San Diego Children's Choir without compensation, except as may be agreed upon in advance for certain projects. This permission slip is a waiver for all choir functions regardless of payment or other benefits to the Choir.
I select to pay by:
E-Signature of Parent or Legal Guardian *
E-Signature of Parent or Legal Guardian
By typing your name below, you acknowledge 1) you are responsible for the transportation of your child to and from all Choir events, and 2) you acknowledge that you are the child's parent or legal guardian and that you have read and reviewed this form.
Today's Date *
Today's Date

Neighborhood Choir Tuition - 12 weeks
180.00

Fall 2017 Session. 

Sibling Discount: $25 of each sibling after the first enrolled. Use code SIBLINGNC at Checkout.

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