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2019 Registration Form and Chorister Paperwork
Royal School of Church Music St. Louis Course
July 15-21st 2019
Registration Form
ST. LOUIS COURSE POLICY /CONSENT/ RELEASE FORM PROGRAM POLICIES AGREEMENT
St. Louis Course Children’s Media Release
Name
*
First
Last
Likes to be Called
Gender
*
Male
Female
Best Contact Email
*
Please use a parents e-mail, as this will be the address that will be used for communication
Age
*
Entering Grade in Fall 2019
*
Please select
4th
5th
6th
7th
8th
9th
10th
11th
12th
Birthday
*
MM
/
DD
/
YYYY
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Best Contact Phone#
*
###
-
###
-
####
Parent(s) or Guardian Name
*
Father's Best Contact Phone#
###
-
###
-
####
Father's Email
Mother's Best Contact Phone#
###
-
###
-
####
Mother's Email
Phone number to be used in case of an Emergency
*
###
-
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-
####
Church Name
*
Church's Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Priest/Clergy Name
*
Choir Director
*
Choir Director's Email
*
Church Phone
*
###
-
###
-
####
ext:
Church Fax
###
-
###
-
####
MEDICAL INFORMATION
Insurance CO.
Policy #
Phone #
Doctor
*
Phone #
Child's Weight
*
Date of last Tetanus Booster
*
Any Known Allergies? or Any known drug sensitivities? (food,insect bites, penicillin etc..)
*
Any known drug sensitivities? (Penicillin, etc)
Are there any over-the-counter products you do not want given to your child? Please specify.
Please note: ALL over-the-counter products will be supplied by RSCM, administered by the course Nurse and minors will not be allowed to have any in their possession. Prescription drugs must be sent in their original container, and will be administered by the course Nurse
If you have a preference for the treatment of he following conditions, please specify:
Headache
Stomachache
Sunburn
Rash
Insect Bite
Any Dietary needs we should know about?
Roomate Request
T-Shirt Size
*
Youth-M
Youth-L
Youth-XL
Adult-S
Adult-M
Adult-L
Adult-XL
Adult-XXL
All Participants receive a Free Shirt, but additional ones can be purchased for $12 each, great for parents or just to have an extra. Would you like to purchase an additional shirt?
Yes
No
If yes, what size?
Are you or your church a member of RSCM?
Yes
No
How would you like to pay your fee?
Check by Mail
Credit Card (Please note that there is an additional fee of $25 for paying by Card)
Send Electric (Facebook, Venmo)
ST. LOUIS COURSE
POLICY /CONSENT/ RELEASE FORM
PROGRAM POLICIES AGREEMENT
***For the Course Participant and Parents/Guardian to read and agree to***
The RSCM Training Courses respect the judgment of all participants. Our policies have been established to help ensure safe and enjoyable courses. The safety of all and the success of the program depend on the actions of each participant. Therefore, any RSCM participant:
• whose attitude, conduct, or behavior is detrimental to the course or to
the reputation of the program;
• who endangers himself or herself or other members of the group in any way;
• who uses or has any drug in their possession which is not administered by the course Nurse; or who uses or has their possession alcohol or tobacco during the course;
will be dismissed from the Course at the discretion of the Executive Director, in consultation with the Staff. Under such circumstances, all additional transportation, communication, accommodation and other expenses incurred by the dismissed participant shall be the responsibility of the participant’s parents or legalguardians. There is no refund whatsoever for participants who are expelled, regardless of the point at which they are dismissed.
By checking the box, the participant agrees to the statement above
I have read and understand the above policies.
*
I have read and understand the above policies.
1. In consideration for allowing my child to participate in The Royal School of Church Music, St. Louis Training Course, We/I hereby release The Royal School of Church Music, St. Louis Training Course, all course volunteers, Todd Hall and employees of Todd Hall who participate in the activities of the course (directly related as well as ancillary thereto), from liability on my behalf of my minor child, based on a claim of negligence arising in any way from my child’s participation in the course and the activities which take place during the course (i.e., all activities of whatever nature from the time my child leaves my care, custody and control in anticipation of the departure the course until the time my child is returned to my care, custody and control after the termination of the course) except to the extent the injury is covered by any insurance procured by The Royal School of Church Music, St. Louis Course, which insurancedoes not allow for subrogation of the claim against the course/retreat center employees or volunteers alleged to have been negligent or to the extent and amount the injury is specifically covered by insurance providing coverage for the person or persons alleged to have been negligent. This release
relates solely to ordinary negligence and does not apply to willful or wanton negligence or intentional misconduct on behalf of any employee or volunteer.
Additionally, We/I specifically agree to indemnify and hold harmless The Royal School of Church Music, St. Louis Training Course, course employees/volunteers, Todd Hall and any employee who participates in any aspect of the course/retreat center from any loss, damage or demand sustained in any way related to my
child’s participation in the above designated course whether from their alleged negligence or otherwise, except with respect to the individual employee or volunteer where the loss is related to willful or wanton negligence or intentional misconduct of that course/retreat center employee or volunteer. This release and
indemnity as to The Royal School of Church Music, St. Louis Training Course and Todd Hall are absolute to the extent not covered by insurance.
2. We/I hereby give authorization and consent for the rendering to my child, by a licensed physician or physicians, of such medical services and treatment as may become necessary or advisable during the aforementioned period of time, regardless of whether such treatment or services become necessary by reason of emergency, unanticipated conditions or otherwise. Such consent and authorization shall include the cooperation and assistance of nurses, technicians, assistants, other physicians, and any qualified medical personnel working under the supervision of licensed physicians.
3. We/I hereby give authorization and consent for my child accompanying you to and from all RSCM related activities from July 17 - 23, 2017 being subject to your supervision during the term thereof.
Parent's/Legal Guardian Name
First
Last
Electric Signature
By Checking the the box below you have agreed to the terms above and allow it to be your digital signature
I agree to the terms
Today's Date
MM
/
DD
/
YYYY
St. Louis Course
Children’s Media Release
In this digital age RSCM America Training Courses take many pictures of worship services, Chorister rehearsals, activities, and performances. We use these pictures to record, promote, and celebrate the Choristers through many different venues including, but not limited to, our individual course website, RSCM America website and Training Courses Brochures, RSCM America Facebook page, slide shows, and publications including RSCM International, etc. We may also use these photos in the raising of money to support the RSCM America, RSCM International, and RSCM Training Courses.
I grant permission for RSCM St. Louis to use any photograph, video, sound and/or written or verbal account of my child(ren) in any media outlet so chosen by RSCM St. Louis or RSCM America and International. This consent shall be retroactive, in that any photograph, video, sound and/or written or verbal account attained previously may be used by RSCM St. Louis or RSCM America and International in any media outlet.
RSCM St. Louis or RSCM America and International promises not to use any account of the child(ren) in a negative, false or destructive fashion, nor will we ever sell photos or give permission to outside agencies to use our media, and will not identify any child by name without written permission.
Electric Signature
By Checking the the box below you have agreed to the terms above and allow it to be your digital signature
I agree to the terms
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