Durham Children's Choir Cantare Registration
Chorister's Name *
Your answer
Chorister's Date of Birth *
Your answer
Chorister's Age *
Your answer
Chorister's Race (optional, used for grant information)
If other, please specify
Your answer
Parent/Guardian Information
Parent/Guardian Name(s) *
Your answer
Street Address *
Your answer
City, State *
Your answer
Zip Code
Your answer
Home Phone Number
Your answer
Parent 1 Email *
Your answer
Parent 2 Email
Your answer
Parent 1 Cell Number *
Your answer
Parent 2 Cell Number
Your answer
If your child has two households, please provide the following for the second household
Parent/Guardian Name(s)-2nd Household
Your answer
Street Address-2nd Household
Your answer
City, State-2nd Household
Your answer
Zip Code-2nd Household
Your answer
Home Phone Number-2nd Household
Your answer
Parent 1 Email-2nd Household
Your answer
Parent 2 Email-2nd Household
Your answer
Parent 1 Cell Number-2nd Household
Your answer
Parent 2 Cell Number-2nd Household
Your answer
Financial Responsibility: If chorister's parents are divorced, who is financially responsible for choir related expenses? Your answer will affect who is included on communications regarding financial matters.
If only 1 parent/guardian, which one?
Your answer
School Information
School Name (Fall 2018) *
Your answer
Grade (Fall 2018) *
Your answer
School Music Teacher's Name
Your answer
Does your child take private lessons? If so, please check all that apply:
If plays instrument, which one?
Your answer
Private lesson teacher and contact information (email):
Your answer
Communications
DCC distributes a Member Directory at the beginning of each year for member use only, which includes contact and school information to assist with communication between members.
Please check one of the following *
Required
Excluded information in Directory
Your answer
Publicity Release
I give my permission to DCC to use my child's photo to help promote the choir in print, such as program brochures, performance programs, DCC website, and any future DCC publications. Full names of children will never appear along with photos in print or on the website. *
Medical Information
Physician/Pediatrician's Name *
Your answer
Physician/Pediatrician's Phone Number *
Your answer
Emergency contact name (in case neither parent/guardian can be reached) *
Your answer
Emergency contact relationship to chorister *
Your answer
Emergency contact cell number *
Your answer
Emergency contact home number
Your answer
Please list any special health problems or considerations, including routine medications, allergies, etc.
Your answer
With supervision, my child may be given the following over-the-counter medications for minor ailments *
Required
Medical Insurance
Subscriber *
Your answer
Relationship to chorister *
Your answer
Insurance Company *
Your answer
Insurance Company phone number *
Your answer
Group Policy Number *
Your answer
Subscriber ID *
Your answer
Do you (parent/guardian) play an instrument well enough to perform during a concert with the choir and would be willing to do so? If so, which instrument?
Your answer
Payment
The registration and tuition fees also include a convenience fee to cover the costs incurred by DCC. You need to pay using the link provided in the submission confirmation to complete your chorister's registration.
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