Registration Form: ECMI Children's Chorus
Thank you for your interest in the Ellsworth Community Music Children's Chorus!
A few notes...
Sessions will be held on Wednesdays, February 3 - May 4, 2016 from 4:00pm to 5:15pm at the General Bryant E. Moore Community Center in Ellsworth, Maine.

Please complete a registration form for each child.

Payments of $25 per child may be sent via check to:

Ellsworth Community Music Institute
PO Box 56
Ellsworth, ME 04605

Alternatively, you may pay via cash/check/credit card at our registration desk on the first day.

Please call us at: 207-664-9258 or email: with questions.
Student First Name *
Student Last Name *
Parent or Guardian First Name *
Parent or Guardian Last Name *
Emergency Contact 1 *
If same as parent listed above, please type "same"
Emergency Contact Phone 1 *
If same as parent listed above, please type "same"
Emergency Contact 2 *
Emergency Contact Phone 2 *
Parent Email *
If no email, please enter "N/A" and include phone below.
Home Phone
Mobile Phone
Mailing Address 1
City *
Student Age
Student Grade
Where did you hear about the ECMI Children's Chorus?
Policies of Ellsworth Community Music Institute
If the Moore Center is open, ECMI is open. The Moore Center does not necessarily follow school closings.

Please check or the ECMI Facebook page, or check for a cancellation notice on WLBZ Channel 2 or their website.

School Delays: Ellsworth Public Schools late starts do not affect ECMI classes.

Unless the student’s family submits a written request to the contrary, photographs of registered students taken during ECMI classes and events are considered eligible for publication and public use. All such student requests will be honored.

ECMI is committed to maintaining an environment where each individual who participates in its programs and attends its events feels safe, respected, and supported. Any individual whose behavior interferes in any way with that environment may, at the sole discretion of ECMI, be asked to withdraw from its programs.

ECMI reserves the right to discontinue a student’s enrollment at any time for reasons including, but not limited to: poor attendance, non-payment of fees, lack of interest or disruptive behavior.

Acknowledgement *
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Question/Message for ECMI
If you would like a printed copy of your completed application, please print BEFORE pressing the submit button.
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