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WORKSHOP ENROLLMENT FORM
SOS4VETS workshops were created to offer veterans and active duty military a springboard to tell their stories in a safe and supportive environment.

This workshop will be facilitated by David St. Romain & Lance Dubroc along with clinicians being present for any specific care needed arising due to the sensitive subjects discussed during the workshop. Additionally, a resource sheet will be offered to participants to take home for any continuum of care needs.

Our free workshop is held on June 19th from 9am - 3pm.

Participants will:
- come together as a group to write a unifying song that highlights each person's input
- share experiences
- record an original song as a group
- receive an digital audio copy of the song

David St Romain currently serves in a multitude of roles, serving as Board President, Facilitator and Volunteer Executive Director. His skills and training include 30+ years and more than 10,000 musical performances with over 100 released recordings. Additional to being a survivor of childhood trauma, David is a previously Certified Facilitator of Darkness to Light’s “Stewards of Children”, “Love146” Human Child Trafficking Prevention, and ChildHelp’s “Speak Up, Be Safe” Abuse Prevention curriculums.

Lance Dubroc is a traveling singer, songwriter, Navy veteran and former public school educator. With his compelling passion for music, he uses the craft to provide a space for people to feel and celebrate openly.

The workshop will be held at the WWII MUSEUM located at:

945 Magazine Street
New Orleans, LA 70130
Email Address *
Participant's Full Name *
Phone Number *
Street Address *
City, State, Zip *
What year were you born?
A catered lunch will be provided. Do you have any dietary restrictions? *
Are you a Veteran?
Clear selection
What branch of service?
Clear selection
How many years did you serve?
Tell us about your musical background and interest. *
Please provide any information that you think we should know about you.
Do you have any questions or comments for us?
MEDIA RELEASE AND INTENT TO DONATE INTELLECTUAL PROPERTY CONSENT: I hereby grant full permission to Songs of Survivors to use, both my image, video, or recorded audio material in any publication or advertising materials (printed or electronic). ****your image may be posted by other participants for which we are not responsible. * I also hereby agree to donate any future rights of intellectual property created at this workshop, including but not limited to, any and all copyrights and any irrevocably sells, assigns, transfers, conveys, and quitclaims to Songs of Survivors, and to all intellectual property rights as to any and all songs created, written, produced, and/or recorded at the Songs of Survivors workshop held on June 19, 2021. A full release will be signed at the registration table before workshop begins. *
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