CSP Youth Summer Registration
Please fill out separate form for each child being registered. Check or online payment may be made for all children registered.
Child's name *
Your answer
School *
Your answer
Grade in Fall of 2017 *
Your answer
Parent/Guardian *
Your answer
Email
Your answer
Address *
Your answer
Best phone number(s) - cell/home/work *
Your answer
Emergency contact other than parent *
Your answer
Relationship *
Your answer
Best phone number for emergency contact *
Your answer
Emergency medical notes
Your answer
Has played instrument for how many years *
Your answer
I give CSP permission to use my child's image for publicity purposes (including social media) *
Please indicate person(s) you approve for pick-up along with their cell numbers. Students will only be released to parents or below persons unless contacted by parent/guardian prior to pick up *
Your answer
We will need to use a CSP instrument. If your child has their own instrument please indicate below. *
Lesson and instrument fee costs (please check the button that applies to your child).
Payment Options
You may pay online at communitystringproject.org or send your check to: CSP, P.O. Box 513, Bristol, RI 02809. Please make checks payable to CSP. When you submit this form you may click the link to our payment page.
Submit
Never submit passwords through Google Forms.
This form was created inside of Community String Project. Report Abuse