Student Registration Form
Email address *
Select your desired activity *
Student Info
Students Full Name *
Your answer
Students Age *
Your answer
Student's School (If Applicable) *
Your answer
Student's Gender *
Parent Information (complete if student is under 18 yrs old)
Parent Name
Your answer
Parent Phone
Your answer
Parent Email
Your answer
Address *
Your answer
How will you be paying? *
Participant Release
I understand that I (or the participant whom I represent) may be photographed, videotaped, and/or audio recorded while participating during this activity. I agree to allow Life Power Music Mentoring to use the participants photograph, video, and/or audio recording in organization publications, media campaign, and promotional materials. I further waive any remuneration for publishing and/or printing such photographs, video, and /or audio recordings. I have read this release and understand all its terms and execute it voluntarily and with full knowledge of its significance. (Type your name below as your digital signature) *
Your answer
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