CYO Member Information Form
The personal information collected on this form is collected under the authority of the Alberta Freedom of Information and Protection of Privacy Act Section 33(c) and is protected by that act. This information will be used for CYO program purposes, and will not be shared with any third party. Red asterisk indicates required fields. Please fill these out accurately.
Member information
First name *
Last name *
Birth date *
MM
/
DD
/
YYYY
Street address *
Apt
City *
Postal Code *
Home phone *
Cell phone *
E-mail *
Instrument played *
Emergency contact Information
Emergency contact *
Relationship to member *
Emergency contact phone *
Father's first name *
Father's last name *
Father's cell phone *
Required for emergency purposes. If your father does not have a cell or work phone number, or e-mail address, please enter "NA" in those fields.
Father's work phone *
Required for emergency purposes. If your father does not have a cell or work phone number, or e-mail address, please enter "NA" in those fields.
Father's e-mail *
Required for emergency purposes. If your father does not have a cell or work phone number, or e-mail address, please enter "NA" in those fields.
Father's address (if different from member)
Street address, city and postal code
Father's home phone (if different from member)
Mother's first name *
Mother's last name *
Mother's cell phone *
Required for emergency purposes. If your mother does not have a cell or work phone number, or e-mail address, please enter "NA" in those fields.
Mother's work phone *
Required for emergency purposes. If your mother does not have a cell or work phone number, or e-mail address, please enter "NA" in those fields.
Mother's e-mail *
Required for emergency purposes. If your mother does not have a cell or work phone number, or e-mail address, please enter "NA" in those fields.
Mother's address (if different from member)
Street address, city and postal code
Mother's home phone (if different from member)
Music Deposit Cheques
Music Deposit cheques will be kept securely in the CYO office. Cheques will not be deposited without just cause. To save postal charges, it is our preference to shred cheques not cashed or have you pick them up at the Conservatory office in June.
Please indicate your preference
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