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Children's Choir Registration

- Ministries

Children's Choir Registration
The maximum number of form submissions has been reached. This form is currently not available.
- Please fill out one registration per child.
  Ages: Grades 3-12
  Rehearsals: Saturdays, 11:30 pm -12:45 pm in Room 104
- Student Information
  
  Student First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child speak English? REQUIRED Yes No Please fill out this field.
  
  Does your child have special needs? If yes, what is the diagnosis? REQUIRED Please fill out this field. Please enter valid data.
  
  School your child attends REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child have allergies? If yes, what are they? REQUIRED Please fill out this field. Please enter valid data.
- Parent/Guardian Information
  
  Parent/Guardian First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to Child REQUIRED Please fill out this field. Please enter valid data.
- I give St. Mary of the Assumption Parish permission to take pictures of my child to be used for publication on the parish website, church bulletin, or for program advertisement purposes. REQUIRED Please fill out this field.
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