EmailMe Form - Spring 2026 Chorus Discovery Day

Singer's Name *

First Last

Age *

Gender *

Female

Male

Prefer not to say

Ethnicity *

Date of Birth *

MM / DD / YYYY

How did you hear about our workshop? *

Are you interested in a same-day audition for your singer after Chorus Discovery Day? *

Yes

No

I'd like them to audition but on a different day

School Information

Please fill out the following information regarding your singer's education

School Attending 2025-2026 *

Music Teacher *

Grade - School Year 2025-2026 *

Parent/Guardian Information

Please fill out completely.

Singer's Home Mailing Address: *

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

Parents or Guardians *

Billing Address (if different)

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

Parent 1/Guardian 1 *

First Last

Cell Phone *

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

Landline / Home Phone

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

Employer:

Work Phone

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

Email - All our communication is done through email. *

Parent 2 / Guardian 2 *

First Last

Cell Phone (2)

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

Landline / Home Phone (2)

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

Employer:(2)

Work Phone (2)

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

Email(2)

Emergency Contact (Other than parents)

First Last

Emergency Contact Address

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

Emergency Contact Phone

First Last

Media Release

In consideration of my child’s participation in the Jacksonville Children’s Chorus / Back-to-School Workshop, I hereby authorize the videotaping, photography, and recording of my child, named in this registration form, 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

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

Pay your registration fee by:

REGISTRATION FEE - $25.00

*online (link provided at the end of the registration form)
* calling our office with a credit card number (904-353-1636 ext. 2)
* mailing in a check or money order
* drop off cash at our office

Jacksonville Children's Chorus
62 Main Street North
Jacksonville , FL 32202

If you have any questions please contact Dale Patricks, Program Coordinator at the office (904) 353-1636 ext. 6 or email: Dale@jaxchildrenschorus.org