Youth Choir Registration

Please submit one form per child

Student Name:
First Name
Middle
Last Name
Birthday:
Grade in September:
School:
Parent Name:
First Name
Middle
Last Name
Parent Name:
First Name
Middle
Last Name
Address *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Allergies/Concerns:*
Home Phone:*
If address is different than students' residence please provide contact information below.
Parent Address:
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Parent's Email: *
I am willing to volunteer with the musical.
ONLY AUTHORIZED INDIVIDUALS BELOW WILL BE ALLOWED TO DROPOFF/PICKUP ANY CHILD. ANY EMERGENCY CHANGES PLEASE CALL 610.399.3377.
Contact One Name: *
First Name
Middle
Last Name
Contact One Phone: *
Contact Two Name:
First Name
Middle
Last Name
Contact Two Phone:
Contact Three Name:
First Name
Middle
Last Name
Contact Three Phone: