Children's Choirs Enrollment 2017-18
One registration form per child

Carolers Choir - PreK (age 4 by August 1) & Kindergarten
Music Makers - 1st-3rd grade
Young Musicians - 4th-6th grade

Child's Name
Your answer
Age
Your answer
Birthdate
MM
/
DD
/
YYYY
Grade in School
(If Preschool, put PS)
Your answer
Home Address / City
Your answer
Zip Code
Your answer
Parent's / Guardian's Names
Your answer
Phone
Your answer
Alternate Phone
Your answer
Email address
Your answer
Names & ages of siblings
Your answer
Name of School
Your answer
Do you attend Sunday School?
If so, where?
Your answer
Has child made a profession of faith?
Has child been baptized?
Does your child play an instrument?
If so, what instrument?
Your answer
How long has he/she played instrument?
Your answer
Special needs / allergies
Your answer
Would you be willing to help in choir for special events or when a teacher is absent?
May we have permission to take and use pictures of your child for purposes of church promotion and/or activities?
Where can parents be reached in case of an emergency?
Your answer
Medical Release: As Parent and/or Guardian, I do hereby authorize the treatment by a qualified and licensed medical doctor of the minor noted above in the event of a medical emergency, which, in the opinion of the attending physician, may endanger his/her life, causing disfigurement, physical impairment, or undue comfort if delayed. This authority is granted only after a reasonable attempt has been made to reach me. This release is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence for the PBC Choir year 9/10/17 through 5/6/18. Typing your name and date constitutes your signature and acceptance of these terms.
Your answer
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