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 *
Your answer
Last name *
Your answer
Birth date *
MM
/
DD
/
YYYY
Street address *
Your answer
Apt
Your answer
City *
Your answer
Postal Code *
Your answer
Home phone *
Your answer
Cell phone *
Your answer
E-mail *
Your answer
Instrument played *
Your answer
Emergency contact Information
Emergency contact *
Your answer
Relationship to member *
Your answer
Emergency contact phone *
Your answer
Father's first name *
Your answer
Father's last name *
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
Father's address (if different from member)
Street address, city and postal code
Your answer
Father's home phone (if different from member)
Your answer
Mother's first name *
Your answer
Mother's last name *
Your answer
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.
Your answer
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.
Your answer
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.
Your answer
Mother's address (if different from member)
Street address, city and postal code
Your answer
Mother's home phone (if different from member)
Your answer
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
Submit
Never submit passwords through Google Forms.
This form was created inside of Google@mtroyal.ca. Report Abuse - Terms of Service - Additional Terms