Music Makes Me Happy Chorus New Member Registration Form
Registration for the 2025-2026 Chorus Year
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Email *
Full Name of Chorus Member *
Birth Date *
If In A Group Home
Name of Agency:
Name of House Manager:
House Manager's Cell Phone:
House Manager's Email:
PARTICIPANT INFORMATION
Participant Address *
Street, City, State and Zip code
Participant Telephone Number *
Participant Email Address *
PARENT/GUARDIAN INFO
Parent/Guardian Name *
Parent/Guardian Address *
Street, City, State & Zip Code
Parent/Guardian Cell Phone Number *
Parent/Guardian Home Phone Number
Parent/Guardian Email Address *
EMERGENCY CONTACTS
RELATIVE, FRIEND, or STAFF:
Name: *
Relationship: *
Emergency Contact's Phone Number: *
Physician name and phone number:
Has the member had previous experience in music? *
Required
If yes, please describe
What are the member’s particular strengths and areas of interest? *
This is very important to us, please elaborate:
What jobs or day programs does the member spend their time doing during the week? *
Please describe:
Physical
What is the member's diagnosis *
What are the member's physical impairments? *
What are the member's physical limitations of movement? *
Is there a history of seizures? *
Required
If so, explain:
Is there any other medical information that would be helpful for the director of the chorus to know about?
If so, please explain:
Food allergies and/or restrictions? *
Required
If so, identify
Emotional
Are there emotional or behavioral characteristics/issues that you can share with us in order for us to be more responsive to the member?
Please explain:
Verbal
Are there special communication problems? *
Required
If so, explain:
Would you suggest any special techniques for communication?
Please explain:
PARTICIPATION FEE
Tuition is $275 per trimester. Please bring check or cash to rehearsal or mail a check to Marsha Martin: 
178 Great Road, Maynard, MA 01754. Make check payable to Music Makes Me Happy, Inc.

Contact Marsha if you are interested in a scholarship.

Required for MMMH Registration:        
(All forms must be completed in full.)
•  Registration Form
•  Signature Form
        •  Payment
A copy of your responses will be emailed to the address you provided.
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