Fort Wayne Children’s Choir Singer Registration 2023-24 Season SINGER INFORMATION Singer's Name: FIRST LAST Birth Date: (MM/DD/YYYY) Singer's name as you wish it to appear in programs: (first and last name only) Choir: ApprenticeChoristerLyricWhitleyTrebleConcertYouth Chorale SELECT SINGER'S T-SHIRT SIZE: —Please choose an option—Youth 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 Add another student?:—Please choose an option—YesNo Singer's Name: FIRST LAST Birth Date: (MM/DD/YYYY) Singer's name as you wish it to appear in programs: (first and last name only) Choir: ApprenticeChoristerLyricWhitleyTrebleConcertYouth Chorale SELECT SINGER'S T-SHIRT SIZE: —Please choose an option—Youth 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 Add another student?:—Please choose an option—YesNo Singer's Name: FIRST LAST Birth Date: (MM/DD/YYYY) Singer's name as you wish it to appear in programs: (first and last name only) Choir: ApprenticeChoristerLyricWhitleyTrebleConcertYouth Chorale SELECT SINGER'S T-SHIRT SIZE: —Please choose an option—Youth 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 Add another student?:—Please choose an option—YesNo Singer's Name: FIRST LAST Birth Date: (MM/DD/YYYY) Singer's name as you wish it to appear in programs: (first and last name only) Choir: ApprenticeChoristerLyricWhitleyTrebleConcertYouth Chorale SELECT SINGER'S T-SHIRT SIZE: —Please choose an option—Youth 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 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 primary email address 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. Choir Secretary: Attend every rehearsal and concert to keep records of attendance and prepare information to go home. Rehearsal Assistant: Attend rehearsals, assist director as needed, and ensure singers remain focused. Greeter: Welcome singers as they arrive for rehearsal and ensure their way to the rehearsal room. Office Admin Tasks Social activities for your singer's choir Choralfest Camp (July 24-28) First AidRehearsal AssistantLunch AssistantConcert 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. PAYMENT OPTIONS: I would like to apply for financial assistance: YesNo Your credit card will not be charged until after your financial assistance application has been reviewed. Please follow this link to the Financial Assistance Form: Financial Assistance Form Payment Information: Enter Secure Payment Info *REQUIRED* PHOTOGRAPHY RELEASE: By my submission of this enrollment form, I hereby give my permission for my child's name, image, and likeness to be used by Fort Wayne Children's Choir in print, photograph, and video marketing materials, whether in print or digital form, in support of its mission and programs, without compensation. 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 the entire choir season. I understand this commitment includes all rehearsals, performances, and travel. I also agree to be on my best behavior and conduct myself appropriately during rehearsals, performances, and travel. 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. (Singers will sign a copy of this statement at their first rehearsal) PARENT CONTRACT: I agree to support the participation of my child in the Fort Wayne Children’s Choir for the entire choir season. I accept the terms of the above medical release, payment options, travel policy, photography policy and related material policy agreements. I understand that even if my child withdraws before the end of the season, I am still responsible for the total amount of tuition due and will be billed for all payments. 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: Date: 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. Δ