2018-2019 registration form

Only one Chorister may be registered at a time.

Chorister's Full Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Birth Date *

Month Day Year

Gender: *

Male Female

Phone Number *

Area Code Phone Number

E-mail Address where you'd like to receive confirmation and information: *

Current Grade *

Name of School

Parent / Guardian Name *

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Parent Guardian Phone Number

Area Code Phone Number

Emergency Contact Name: (if parent/guardian not reachable) *

First Name Last Name

Emergency Contact Relationship: *

Emergency Contact Day Phone Number: *

Area Code Phone Number

I hereby give permission for the aforementioned chorister to attend and participate in Alaska Youth Choir activities and rehearsals. I hereby agree to hold harmless and release from liability the Alaska Youth Choir and any representative thereof for any action, claim, or damage that may arise as a result of his/her participation in choir activities. I hereby agree to comply with all rules and restrictions governing him/her set forth by Alaska Youth Choir and explained in the Handbook. I hereby give my permission for any authorized representative of Alaska Youth Choir to obtain service of and/or advice from an available physician or other medical personnel for him/her in case of illness or injury, including any necessary transportation for such emergency care. I hereby agree to assume ALL responsibility for any costs as a result of such medical care.

I furthermore understand the Alaska Youth Choir often takes photographs or videos of participants during its activities or events. I grant permission without compensation that these photographs or videos may be used in publications, presentations, websites or promotion of the Alaska Youth Choir and the HeART of Singing Summer Vocal Camp. The Alaska Youth Choir will not identify my child by name, or release any other personal information without additional written permission from me.

Electronic Signature: By entering my name below, I accept the above conditions and releases. (You must be 18 years old or over to sign below.) *

First Name Last Name

Relationship to registered Chorister: *

Current Date: *

Month Day Year

Payment is due upon acceptance in one of the 3 choirs;

FULL YEAR
Prep Choir - $400.00
Intermediate Choir - $600.00
Advanced Choir - $800.00

SEMESTER
Prep Choir - $300
Intermediate Choir - $400
Advanced Choir - $500

Payment plans and scholarships are available contact Amy at 789-1941

If a chorister has to withdraw it must be done in writing to the Business Administrator. The refund policy will be as follows (with 1^st rehearsal being counted as the 1^st day). If written withdrawal is received within:

10 days of the 1 ^st rehearsal then 100% on the Tuition Agreement Amount for the chorister will be refunded minus a $50 administrative Fee.
20 days of the 1 ^st rehearsal then 75% on the Tuition Agreement Amount for the chorister will be refunded minus a $50 administrative Fee.
30 days of the 1 ^st rehearsal then 50% on the Tuition Agreement Amount for the chorister will be refunded minus a $50 administrative Fee.

*The AYC depends on reliable and timely tuition payments. The Refund Policy is structured in such a way that payment may be further due depending on the day of withdrawal and payments made. AYC will not refund any tuition after the 30^th day.

Upon completion of filling in all areas of form, click "Submit Form". You will then be contacted by our business administrator regarding auditions. Only one chorister may be registered at a time. You may click "Print Form" to print a copy of this form. Do you have questions or need help with online registration? Email Amy at alaskayouthchoir@gmail.com.

2018-2019 Registration

PARENT / GUARDIAN INFORMATION

Liability/Photo/Video Release

Payment

Refund Policy