EmailMe Form - JCC Vocal Exploration Spring 2019

Singer's Name *

First Last

Vocal Exploration *

Mondays - 5:45pm-6:30pm

Gender *

Female

Male

Age *

Grade *

2nd

3rd

4th

5th

Date of Birth *

MM / DD / YYYY

School Attending 2018-2019 *

Music Teacher *

Ethnicity *

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

Parent 1/Guardian 1 Home Mailing Address: *

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

Land Line

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

Employer:

Work Phone

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

Cell Phone

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

Email *

Parent 2/Guardian contact information

Name(2)

First Last

Parent 2/Guardian 2 Home Mailing Address:

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

Home Phone (2)

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

Employer:(2)

Work Phone (2)

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

Cell Phone (2)

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

Email(2)

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: $182.00
Registration Fee: $25.00 (Non-refundable).
Total: $207.00

Registration fee is due at the time of enrollment.
Tuition is due no later than April 1st.

After submitting this registration form, you will be redirected to the payment page. YOU MUST MAKE YOUR $25 REGISTRATION PAYMENT IN ORDER TO BE FULLY REGISTERED.

You can also pay your registration fee by:

| paying via link in acceptance letter | 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

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

Agreement *

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