EmailMe Form - Primary Choir Spring 2019

Singer's Name *

First Last

Primary Choir
Rehearsals begin February 14, 2019 *

Thursday 4:15-5:00pm BEACHES (Palms Presbyterian Church, 3410 3rd St S, Jacksonville Beach, FL 32250)

Thursday - 4:45-5:30pm DOWNTOWN (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 2018-2019 *

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 parent/volunteer auxiliary support group 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 hereby 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 February 26, 2019

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

Options to pay your registration fee:
* Pay online. This form will be redirected to the online payment system.
* Call our office with credit card number (353-1636)
* Mail check or money order
* Drop off cash at our office
Address:
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