Choir Registration

HG Choir Registration

* Indicates required field

Singer's Name *

First

Last

Singer's School *

Select Choir *

Treble Choir (Grades 4-8) Choir Too (Grades 2-4)

Age *

Grade *

Parent/Guardian Name *

First

Last

Parent Guardian Mobile Phone *

Parent/Guardian Work Phone *

Parent/Guardian Address *

Parent/Guardian Email *

Emergency Contact Name *

Emergency Contact Phone *

Emergency Contact Relationship to Singer *

Allergies/Medical Conditions/Special Needs/Dietary Restrictions (or "none") *

Physician's Name & Phone *

Medical Release:
In the unlikely event that my child becomes ill or injured and I or the authorized physician named on the form cannot be immediately contacted at the time of the emergency, and if the judgement of the staff of HGC is that immediate observation and/or treatment is necessary I hereby authorize and direct the staff of HGC to send my child (properly accompanied by an adult) to the hospital or physician most easily accessible. Further, I release Hamilton-Gibson Productions and their employees or agents from any and all claims in connection therewith. By submitting this form, I accept the medical release terms of agreement.

Photographic Consent and Release:
I hereby consent and agree that Hamilton-Gibson Productions (HG) has the right to take photos or record video of my child participating in choir activities, and to use these in marketing materials to promote the choirs activities including print, media, or online. I hereby release to HG all rights to exhibit this work in front or electronic form. I agree that any uses described herein may be mad without compensation or additional consideration. I represent that I am at least 18 years of age, have read and understand the foregoing statements, and am legally responsible to execute this agreement. By submitting this form, I agree to the HG photographic consent and release.

Terms Agreement *

By checking here, I agree to the medical release and photographic consent and release terms of agreement.

Choir tuition is $40 per year. Assistance is available through the Katherine A Brennan Scholarship Fund for families that qualify. Will you be applying for a scholarship?

Scholarship *

Yes No