2025 Hart Choir Disneyland Trip - CHAPERONE Registration
Thank you for your interest in being a chaperone!

Cost for Chaperones is $500, but no deposit is due until you receive a confirmation for the trip.  We will be looking for a balance of male and female chaperones and will try to accommodate as many parents as we can, but please understand we may not be able to bring all parents who express interest.   Chaperones must be Level 2 cleared by PUSD and the cost of required PUSD volunteer clearance (LiveScan background check & fingerprinting, TB clearance, etc) may be additional out of pocket expenses (Note: A voucher for LiveScan may requested from the district, more information can be found here).  Additional overnight volunteer forms will also need to be completed.

Payment - follow instructions to pay found on the Traveler Information and Payment Schedule document.  Chaperones can pay in full by November 4.

Each Chaperone will be responsible for 8-10 students.  Chaperones are expected to attend all events with children and ride on the bus with students.

Rooms are double capacity, they are a 1 bedroom suite with two queen beds, and a pull out sofa bed in the living area.

Single room options for chaperones may be requested for an additional charge based on availability. Please contact Annie Kao for more information at choirtrip@thomashartmusic.org.
Email *
Your Student's First and Last Name
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CHAPERONE INFORMATION
Chaperone LAST Name
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Chaperone FIRST Name
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Birth Date
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MM
/
DD
/
YYYY
Gender
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Mobile Phone
*
Please use a XXX-XXX-XXXX format (ie. 925-123-4567)
Email
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EMERGENCY & MEDICAL INFORMATION
Medical Insurance
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Policy Number *
Emergency Contact
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Emergency Contact Phone Number
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Food Preferences
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Required
Other Allergies/Special Food Information
OTHER INFORMATION
Roommate Request:
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  1. Provide NAME OF REQUESTED ROOMMATE
  2. OR, if no request enter "NO PREFERENCE" 
  3. OR, If you want a single room list "SINGLE" (subject to availability)
  4. OR, if not sure enter “TBD”
Adult T-Shirt Size
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Other information you would like to share with organizers
If my registration is accepted, I agree to pay a total of $500 for the 2025 Hart Choir Disneyland Trip, Chaperone cost.

$100 non-refundable deposit due no later than 9/15/24
$400 payment with final due date of 11/03/24.

Type your full name here if agree to payment schedule.
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