• KETTERING CHILDRENS CHOIR

    SINGER REGISTRATION & MEDICAL RELEASE
  • Please complete this form to ensure your 2020-2021 place in the choir.  

  • Parent/Guardian/Singer and Additional Contact Information

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  • Emergency Information

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  • Medical Release and Authorization

    In the unlikely event that my child becomes ill or is injured, and I, or the authorized physician named, cannot be immediately contacted at the time of an emergency, and if in the judgment of the staff of the Kettering Children’s Choir immediate observation or treatment is necessary, I authorize and direct the staff to send my child (properly accompanied) to the hospital or physician most easily accessible.  I release the Kettering Children’s Choir, their employees, and agents from any claim of liability in connections therewith.

  • PHOTOGRAPHIC RELEASE

    The undersigned agrees without compensation to permit The Kettering
    Children’s Choir, its agents, assignees and employees to use photographic
    images or likenesses of the below listed singer(s) for use and benefit of
    The Kettering Children’s Choir in its publications and other organizational
    development and promotional programs. This release shall continue in
    force until specifically revoked.

  • Commitment Statement

    WE UNDERSTAND THAT THE SINGER IS MAKING A FULL-YEAR COMMITMENT AND AGREE TO PARTICIPATE FOR THE ENTIRE SEASON. WE ALSO UNDERSTAND THAT WE ARE MAKING A FINANCIAL COMMITMENT FOR THE COMPLETE TUITION RATE, WHICH IS NON-REFUNDABLE. 

    Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

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