Saint Paul's Choir School Summer Program Sign-Up 2024
29 Mount Auburn Street, Cambridge MA 02138 (617) 868-8658
Week of Summer Program:
Which week of the Summer Program will your child attend?
June 24-28, 2024
August 19-23, 2024
Both
CHILD INFORMATION:
Child Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
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1928
1927
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1925
1924
1923
1922
1921
1920
Year
Age
*
Please type your child's current age.
Name of Current School
*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian 1 Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Alternate/Work Phone Number
-
Area Code
Phone Number
E-mail
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Parent/Guardian 2 Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
E-mail
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
MEDICAL INFORMATION
Physician Name
*
First Name
Last Name
Physician Phone Number
*
-
Area Code
Phone Number
Allergies
*
If none, type NO.
Allergy Medications & Plan
*
Please indicate here which medications your child may require for his or her allergies. If your son or daughter has a prescription for an Epi-Pen or similar, we will require that one be kept onsite. Further, please advise if you have a doctor's written allergy plan; if so, we will require a copy. If none of this applies, type NO.
Medical Concerns (Non Allergy)
*
Please include necessary medications and/or other health concerns that we should be aware of in providing care for your child. If none, type NO.
Insurance Provider
*
Include Group Number above, if applicable
Policy Information
*
Policy Number
Provider Phone Number
Primary Emergency Contact
*
Name
Phone Number
Secondary Emergency Contact
*
Name
Phone Number
Scholarship Requests:
Please reply YES below if you would like to inquire about a scholarship. Be sure that your email and phone number, as entered above, are accurate so that we can reach out with additional details. If you are a currently enrolled parent at the school, you receive an automatic scholarship credit of $225 per week of summer program.
Scholarship Requested?
Medical Care Release:
I hereby delegate authority to the Directors of the Saint Paul's Choir School Summer Program to arrange whatever medical treatment they deem necessary for my child during his/her program day (from arrival until pick-up, June 24-28 and August 19-23, 2024). Please type your name below as your digital signature.
Medical Care Release Signature
*
First Name
Last Name
Participation and Liability Waiver:
I hereby give permission for our son/daughter to participate in all activities conducted by SPCS. We agree to hold the directors and staff harmless from any liability to anyone on account of any injuries to our son. I understand that SPCS cannot be responsible for lost or broken items. I understand my son/daughter will comply with all program policies and procedures. I also understand, and will comply with, all cancellation policies and procedures. Please type your name below as your digital signature.
Participation and Liability Waiver Signature
*
First Name
Last Name
Photo Release:
St. Paul’s Choir School has my permission for the child named above to be photographed and/or videotaped. I realize that the photo may be published in the newspaper, a magazine, the school website, television or other publications. The video may be used for informational or educational purposes to promote the mission of The St. Paul’s Choir School. Please type your name below as your digital signature.
Photo Release Signature
*
First Name
Last Name
Contact Us:
(617) 868-8658 / admissions@saintpaulschoirschool.us / pmoran@saintpaulschoirschool.us
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