Registration Form
Thank you for registering your child to GleeCeptional Junior! Looking forward to working with your singer!
Email address *
Demographics
Gleeceptional Season *
Age Group *
Parent/Guardian Name #1: *
Your answer
Parent/Guardian Phone Number #1: *
Your answer
Parent/Guardian Name #2: *
Your answer
Parent/Guardian Phone Number #2: *
Your answer
Parent/Guardian Email *
Your answer
Mailing Address: *
Your answer
Singer Details
Singer's Name: *
Your answer
Singer's Age: *
Your answer
Singer's Birthday: *
MM
/
DD
/
YYYY
What is your child's medical diagnosis? *
Your answer
Gender: *
Emergency Contact #1: Name, Number and Relationship. *
Your answer
Emergency Contact #2: Name, Number and Relationship. *
Your answer
Have you: *
Required
Any Allergies? *
If so, what are their allergies?
Your answer
Do your child have any physical or breathing limitations? Please explain. *
Your answer
Dietary restrictions
Do you require an attendant present? *
Please provide in detail, information about your child that can help us to better instruct him/her. *
Your answer
Does your singer have any behaviours? Please explain any triggers or ways in which can help us to better coach them. *
Your answer
Do you consent that pictures can be taken of your child and used for promotional usage? *
Comments/Questions?
Your answer
Singer's T-Shirt size: *
Are you a: *
Required
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