Beaches Children’s Choir

                     SUMMER Registration                   

Child’s name ___________________________________________   M / F

Birth Date _____________    T-shirt Size: S6-8   M10-12   L14-16   Adult S

Parent’s Names _________________________________________________

Address_______________________________________________ ZIP ______

Home Phone __________ work _________  cell _______

Email__________________________

Emergency contact _______________________________

1. I agree to pay the summer program fee of $85 due with registration form. This covers the weekly program and a T-shirt.  50% of this is refundable if written notice is provided at least 2-weeks prior to the start of the summer program. The rest is non-refundable.
2. I authorize the use of photographs of my child taken during this program for choir promotion.
3. I agree to hold Beaches Children’s Choir, its choir Director, its volunteers, sponsors, and the host site, Neptune Baptist Church, harmless from any and all claims of injury or harm suffered by my child from participation in choir activities.

Scholarships are available. See the Director to apply.

I HEREBY CERTIFY THAT I HAVE READ AND UNDERSTOOD THE FOREGOING.

Parent’s Signature____________________________________________________

Witness___________________________________________

Date______________________________________________