Voices in the Laurel 2020-2021 Registration
Register for the 2020-2021 Voices in the Laurel season!
Email address *
Chorister's First Name
Chorister's Last Name
Nickname
Gender
Clear selection
Age
Date of Birth
MM
/
DD
/
YYYY
School
Grade in upcoming school year
Number of year in Voices in the Laurel
Ethnic Data (State and local grants require the choir to report ethnic data)
T Shirt Size
Parents name(s) *
Choristers Mailing Address (please provide City, state and zip) *
Parents phone number (please provide home, cell and work of each parent) *
Chorister's email (if applicable)
Parents email address *
Name and relationship of emergency contact *
Phone number(s) of emergency contact *
School Music involvement
Church music involvement
Private Music lessons
Other recreational activities
Choristers Physician
Physician's phone number
Is the Chorister covered by health insurance
Clear selection
Health insurance company
Health Insurance Group #
health insurance ID#
Does the chorister have any allergies?
Health History (Please check if the chorister has)
If yes to any of the above, please explain
Any surgical history?
Any hospitalizations? If yes, please explain
Please read the following statement and type your name if you agree: I consent to allow for my child to participate in Voices in the Laurel.. I consent to allow Voices in the Laurel to use my child's picture, video and / or voice for social media purposes. I understand that Voices in the Laurel has full ownership of any videos and / or pictures and can use for any marketing purposes (social media, newspaper, tv...etc). I consent that all of the information provided is true and I will not hold Voices in the Laurel responsible for anything that I may have omitted in this form. *
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