HATS! Registration
Chorus Abilene Summer Musical Camp, July 30 - Aug. 3, 2018
Camper Name
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Address, City, ST Zip
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Home Phone #
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Cell Phone #, if different
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Parent Email Address
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Camper Birthdate: mm/dd/year
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Camper grade for Fall, 2018
Camper School for Fall, 2018
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Camper Gender
Doe your camper have allergies we should be aware of?
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Parent Name
Your answer
I hereby grant permission for a Chorus Abilene camp teacher to give consent for medical treatment for my child/children, in the event that they are unable to contact me.
Required
I further grant permission to have such diagnostic and/or treatment procedures performed on my child as are deemed necessary by duly authorized attending physicians of hospital, private doctor and/or health department.
Required
I further grant authority to release such medical information regarding as may be requested by other physicians, or other health agencies to which I have applied, or may in the future apply for service or assistance.
Required
I hereby consent that the videotapes, photographs, and/or audio recordings made of his/her voice may be used by Chorus Abilene, its assigns or successors, in whatever way they desire, including television and the Chorus Abilene website. Furthermore, I hereby consent that such photographs, films, and recordings and the plates and/or tapes from which they are made, shall be the property of the Chorus Abilene, Inc., and Chorus Abilene has the right to sell, duplicate, reproduce, and make other uses of such photographs, films, recordings, plates, and tapes as they may desire free and clear of any claim whatsoever on my part. I understand that my child will not be named individually except by separate permission.
Required
I plan to pay my non-refundable deposit of $50:
I understand that by entering my name in the space below, I signify all information is correct.
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