SINGER INFORMATION

Singer's Name:
FIRST LAST
Birth Date: (MM/DD/YYYY)

SELECT SINGER'S T-SHIRT SIZE:
—Please choose an option—Youth SYouth MYouth LAdult SAdult MAdult LAdult XLAdult XXL

Lives with: (if other, please state with whom below)
mother and fathermotherfatherother

Gender: malefemale

Race: African American/BlackAsianBi-racialCaucasianHispanic/LatinxOther
School:
School Corporation:
Grade in Fall:

MEDICAL INFORMATION

Prescription medications: (please explain)

Allergies:
Does your child carry an EPI Pen? yesno
Please list any special health conditions:

Important: Does your child have an Individual Education Program (IEP)? In order to serve your child, would you be willing to share that information with FWCC? YesNo

Does your child have any behavioral, social, or emotional challenges, that would be helpful for us to know?

Add another student?:—Please choose an option—YesNo

PARENT/GUARDIAN INFORMATION

FATHER'S/GUARDIAN'S INFORMATION

Name:
FIRST LAST
Address:
City:
State:
Zip:
Cell Phone:
Contact E-Mail:
Employer:
Occupation:
Work Phone:
May we call you at work? yesno

MOTHER'S/GUARDIAN'S INFORMATION

Name:
FIRST LAST
Address:
City:
State:
Zip:
Cell Phone:
Contact E-Mail:
Employer:
Occupation:
Work Phone:
May we call you at work? yesno

IMPORTANT:
Please enter the email address(es) in which you prefer we communicate:

HOW PARENTS CAN HELP: The commitment of both singers and parents is essential to the success of the FWCC. Parent involvement is needed and appreciated. Please check the areas below where you would like to volunteer.

Choralfest Camp (July 21-25) First AidChoralfest Camp (July 21-25) Lunch Assistant

*The following sections are to be reviewed by the parent(s)/guardian(s) of each singer. Please check the acceptance box for each section. If one is missed, there may an error when submitting.*

MEDICAL AND EMERGENCY INFORMATION

Emergency contacts (other than parent) if parent/guardian cannot be reached (please list two):

Emergency Contact Name #1: (first and last name)
Phone:
Relationship:

Emergency Contact Name #2: (first and last name)
Phone:
Relationship:

MEDICAL RELEASE: In the unlikely event that my child becomes ill, and I cannot be immediately contacted at the time of the emergency, and if in the judgment of the staff of the Fort Wayne Children’s Choir, immediate observation or treatment is necessary, I authorize and direct the staff to accompany my child to the hospital or physician most easily accessible.

PHOTOGRAPHY RELEASE:
By my submission of the enrollment form, the Fort Wayne Children's Choir has my permission to photograph and record my child and to use the photographs and video footage publicly to promote the Fort Wayne Children’s Choir. I understand that the images and recordings may be used in print publications, presentations, websites, social media, and news outlets. The Fort Wayne Children’s Choir reserves the right to share content with media outlets and third party collaborators. I also understand that no royalty, fee, or other compensation shall be payable to me by reason of such use.

SINGER CONTRACT:
As a singer in the Fort Wayne Children’s Choir, I agree to make my participation a high priority and to honor this commitment for Choralfest Camp. I understand this commitment includes participating in the camp fully, including the Choralfest Concert. I also agree to be on my best behavior and conduct myself appropriately during Choralfest Camp. I understand the director is in charge and has the authority to remove me from a rehearsal or performance if my behavior or level of participation is inappropriate and/or detrimental to the orderly progress of the choir.

PARENT CONTRACT:
I agree to support the participation of my child in the Fort Wayne Children’s Choir Choralfest Camp. I accept the terms of the above medical release, photography policy, and related material policy agreements. I understand that even if my child withdraws before the end of Choralfest Camp, I am still responsible for the total amount of tuition due. Outstanding balances are subject to include attorney fees, court costs and other related expenses. I have reviewed the Singer Contract with my child and accept responsibility for my child.
(Please sign in the space below. Desktop users may use your mouse; mobile users may use their finger or stylus.)
Parent/Guardian Signature:

Important! Please be sure to review this form and verify that all of the required fields are complete prior to submitting. If you are unable to submit the form or receive an error message, make sure you have checked all "accept terms" boxes and try submitting again.

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