2022 Music Monday Virtual Choir Registration

en français
MUSIC IS OUR MEDICINE - MUSIC MONDAY 2022 YOUTH VIRTUAL CHOIR REGISTRATION

Thank you for registering to participate in our Music is our Medicine virtual choir. You will receive a username and password to access all the learning materials. Watch our HOW TO video for instructions, recording tips, and it also includes a recording of the song with lyrics you can sing along to when you record yourself.
Name (will not appear in the virtual choir video) *
(Full name, nickname or stage name)
Pronouns
e.g. they, she, he, etc
Title *
e.g. grade 11 student, jazz pianist, chorister, elementary music teacher, etc
Mailing Address (For Music Monday Gift)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Are you a member of a choir? If you would like your choir to be acknowledged in our credits, please list it here:
e.g. band, school, professional organization
Tshirt Size
I am: *

An individual contributor (age 18+) An individual contributor (under the age of 18)

Consent Form (Participants Over 18 Years of Age)
I, (legal first name)* (legal last name)* , give the Coalition for Music Education in Canada permission to use the attached content.

I acknowledge that:
- My image or video might be used for future promotional materials (website, highlight videos, social media, etc) or in pursuit of grants or funding.
- I have obtained permission to record everyone visible in my video/photograph
Signature *

Please sign using your mouse, trackpad, or finger Clear
Email address *
example@example.com

Parent/Guardian Consent (Participants Under 18 Years of Age)
On behalf of (first name of participant under 18)* (last name of participant under 18),*
I, (first name of parent/guardian)* (last name of parent/guardian)*, give the Coalition for Music Education in Canada permission to use the attached content.

I acknowledge that:
- My image or video might be used for future promotional materials (website, highlight videos, social media, etc) or in pursuit of grants or funding.
- I have obtained permission to record everyone visible in my video/photograph
Signature of Parent or Guardian *

Please sign using your mouse, trackpad, or finger Clear
Email address of parent or guardian *
example@example.com
Email address of participant under age 18
example@example.com
Should be Empty:

MUSIC IS OUR MEDICINE - MUSIC MONDAY 2022 YOUTH VIRTUAL CHOIR REGISTRATION