Greatland Youth Chorus Registration
Please complete and submit this form to reserve a seat for the 2020 Spring Semester. Please submit one form per student. No payment is due at this time. Spring 2020 Registration is for the Youth Chorus only. If you are interested in the Band program please contact Jessica Swan directly at jessica@greatlandyouthchorus.com.
Contact Information
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
E-Mail Address *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Best Phone Contact *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Student Information
Student First Name *
Your answer
Student Last Name *
Your answer
Sex *
Student Grade (2019-2020 School Year) *
Special Concerns: Please list any medical or other needs that the instructor should be aware of, i.e. allergies, asthma, learning challenges, etc.
Your answer
Directory
I agree to have our contact information included in the Greatland Youth Chorus and Band directory to be distributed to members. *
Media Release
I grant permission for my child to participate and appear in video or audio recordings, photographs, written articles, or on websites and social media sites for the Greatland Youth Chorus/Band and its programs. This consent includes the use and editing of my child's image, voice, and name in media projects by the Greatland Youth Chorus/Band and its programs. In consideration of the opportunity for my child to participate, I release the Greatland Youth Chorus/Band from all claims resulting from the use and editing of my child's image, voice, or name, and the use, editing, and release to media outlets. *
Payment & Withdrawal
Direct bill homeschool program? *
School/Homeschool Program (2019-2020 School Year) *
Payment is the parent's responsibility. If you are using allotment funds from your homeschool program, please ensure that this class is covered by your learning plan, meets the guidelines of your program, and that you have sufficient funds available in your allotment to pay the required tuition. If your homeschool program allotment has insufficient funds to cover the full tuition, you will be responsible for the balance, to be paid within 30 days of the final rehearsal/class. *
Required
Full tuition payment or a signed authorization to direct bill your homeschool program must be submitted by the second rehearsal/class of each semester. You may withdraw after the second class session without penalty. If you withdraw after the third session, you will be responsible for the full semester tuition fee. *
Required
Permission to Participate
My child may fully participate in the programs of the Greatland Youth Chorus (Chorus and/or Band), excluding anything listed under "special concerns" above. *
Required
Required recital dress includes black bottoms (pants/skirt for girls, pants for boys) and white top (blouse or nice top for girls, collared shirt - dress or polo - for boys). My child will dress appropriately for all performance recitals. *
Required
Release of Liability
I understand that although the students will be supervised by Jessica Swan and the Greatland Youth Chorus staff and volunteers, I do assume the risk in my child’s participation in rehearsals, performances, and activities. I acknowledge that I will not seek to have the Greatland Youth Chorus and its programs, Jessica Swan or any other staff or volunteer held liable in the event that any accident, injury, loss of property or any other incident occurs during or as a result of my child’s participation in rehearsals, performances, or activities. This Release of Liability includes accident, injury, loss of property, or damages to my child, as well as, to other individuals or property which may result from my child’s participation in the rehearsals, classes, performances, and activities of the Greatland Youth Chorus and its programs. I hereby release and agree to hold harmless the Greatland Youth Chorus and its programs, Jessica Swan, and other staff and volunteers from any claims arising out of my child’s participation in classes, rehearsals, performances, or activities. I have read the above statements. I understand all of the above statements and accept full responsibility as described. I accept this Release of Liability by typing my full name below. *
Your answer
Additional Information
How did you hear about the Greatland Youth Chorus?
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Comments
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