Membership Application
Youth Jazz Collaborative
Email address *
Parent Name *
Your answer
Parent Email *
Your answer
Parent Address *
Your answer
Parent Phone number *
Your answer
Student Name *
Your answer
Student Email
Your answer
Student Phone Number
Your answer
School *
Your answer
Grade *
Instrument
Comments
Your answer
Class Selection *
Required
I am the legal guardian of this student and he/she has my permission to come to the selected class/es. I will be responsible for transportation to and from the classes. *
I give unrestricted permission to Youth Jazz Collaborative for images, videos, and recordings of the child to be used in print, video, digital and internet media. I agree that these images and/or voice recordings may be used for a variety of purposes and that these images may be used without further notifying me.I further acknowledge that I will not be compensated for these uses. *
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