EmailMe Form - Primary Choir Fall 2017

Singer's Name *

First Last

Primary Choir
Rehearsals begin the week of September 25th, 2017 *

Monday- 4:00-4:45pm (Destination Church, 88 Arlington Rd., Jacksonville, FL 32211)

Tuesday - 4:00pm-4:45pm (First Coast Christian School, 7587 Blanding Blvd, Jacksonville, FL 32244)

Thursday - 4:00-4:45pm (First United Methodist Church, 225 E. Duval St, Jacksonville, FL 32202)

Gender *

Female

Male

Age *

Grade *

K

1st

Date of Birth *

MM / DD / YYYY

School Attending 2017-2018 *

Music Teacher *

Ethnicity *

Parents or Guardians *

Singer's Home Mailing Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Billing Address (if different)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Parent 1/Guardian 1 Contact information

Name *

First Last

Home Phone *

### - ### - ####

Employer:

Work Phone

### - ### - ####

Cell Phone

### - ### - ####

Email *

Parent 2/Guardian contact information

Name(2)

First Last

Home Phone (2)

### - ### - ####

Employer:(2)

Work Phone (2)

### - ### - ####

Cell Phone (2)

### - ### - ####

Email(2)

JCC Parent Volunteer Auxiliary
The In Harmony Guild is the JCC's new parent/volunteer auxiliary support group. The Guild will work with singers, parents, and JCC staff to foster social interaction, enhance communication, and promote the mission of the JCC. Members are welcome and appreciated! *

Yes!

No, Thank you.

In consideration of my child's participation in the Jacksonville Children's Chorus, I heareby authorize the videotaping, photography, and recording of the above referenced registrant, and/or release of his/her name and achievements for educational, promotional, and other purposes deemed appropriate by officers of the Jacksonville Children's Chorus. I also authorize the use of the videotape/photography and other information regarding my child in printed matter or other media for presentations by the Jacksonville Children's Chorus without my further consent. I hereby agree that such media information shall be the sole property of the Jacksonville Children's Chorus. *

I agree

TUITION AND FEES

Tuition: $252.00
Registration Fee: $25.00 (Non-refundable).
Total: $277.00

Registration fee is due now.
Tuition is due on or before October 25, 2017.

AFTER SUBMITTING THIS REGISTRATION FORM, YOU MUST MAKE YOUR $25 REGISTRATION PAYMENT IN ORDER TO BE FULLY REGISTERED.

Pay your registration fee by:

paying online. This form will be redirected to the online payment system.
calling our office with a credit card number (353-1636)
* mailing in a check or money order
* drop off cash at our office

Jacksonville Children's Chorus
225 E. Duval Street
Jacksonville , FL 32202

If you have any questions please call the office (904) 353-1636

Agreement *

I agree to pay the complete tuition, and registration fee.

How did you hear about us? *

Parent 1/Guardian 1 Contact information

Parent 2/Guardian contact information

TUITION AND FEES Tuition: $252.00 Registration Fee: $25.00 (Non-refundable). Total: $277.00

TUITION AND FEES

Tuition: $252.00
Registration Fee: $25.00 (Non-refundable).
Total: $277.00