EmailMe Form - Kids Praise Choir Registration

Is This a Returning Choir Member?

Yes

No

Student's Name *

First Last

Family Last Name (if different than student)

Student Age

Birthday

Grade in School *

School Attending

Preferred Email for Communications *

Mother's Name

First Last

Mother's Cell Phone

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

Mother's Email

Father's Name

First Last

Father's Cell Phone

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

Father's Email

Student Home Address

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

Allergies

Other activities student is involved in outside of school