2024 Gateway Community Youth Chorus Member Agreement

2024 Gateway Community Youth Chorus Member Agreement
General Information
Student Name*

First NameLast Name
Student Gender*

MaleFemaleOther
Student Grade*

3rd4th5th6th
Student T-Shirt Size*
Student Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*

Area CodePhone Number
Parent/Guardian Email*
example@example.com
Attendance Policy
SCHEDULE

*attendance required

Tuesday, September 10th | 6-7pm
Tuesday, September 17th | 6-7pm
*Tuesday, September 24th | 6-7pm - 1st Workshop

Tuesday, October 1st | NO REHEARSAL
Tuesday, October 8th | 6-7pm
Tuesday, October 15th | 6-7pm
Tuesday, October 22nd | 6-7pm
Tuesday, October 29th | 6-7pm

*Tuesday, November 5th | 6-7pm - 2nd Workshop
Tuesday, November 12th | 6-7pm
Tuesday, November 19th | 6-7pm
Tuesday, November 26th | NO REHEARSAL (Holiday)

Tuesday, December 3rd | 6-7pm
*Tuesday, December 10th - Small Winter Concert

Tuesday, January 14th | 6-7pm
Tuesday, January 21st | 6-7pm
Tuesday, January 28th | 6-7pm

*Tuesday, February 4th | 6-7pm - 3rd Workshop
Tuesday, February 11th | 6-7pm
Tuesday, February 18th | 6-7pm
Tuesday, February 25th | 6-7pm

*Tuesday, March 4th | 6-7pm - 4th Workshop
Tuesday, March 11th | 6-7pm
Tuesday, March 18th | 6-7pm
Tuesday, March 25th | 6-7pm

*Tuesday, April 1st | 6-7pm - 5th Workshop
Tuesday, April 8th | NO REHEARSAL (Spring Break)
Tuesday, April 15th | 6-7pm
Tuesday, April 22nd | 6-7pm
Tuesday, April 29th | 6-7pm

Tuesday, May 6th | 6-7pm
Tuesday, May 13th | 6-7pm
*Tuesday, May 20th | Spring Concert
Do you understand that your student MUST be present for the *noted dates above?*

I understand
Due to limited rehearsals, students are allowed 3 absences total. Exceptions only for emergencies. If more than 3 rehearsals are missed, the student will be removed from the choir.*

I understand
Member Agreement

This portion needs to be gone over, filled out, and signed by the student
As a member of the Gateway Community Youth Chorus I commit to:*

To be friendly, kind, and respectful to all members of the choir, the choral director, and visiting guest artistsIf I am not well enough to sing, but am well enough to be at rehearsal, I will attend and learn without singingI will focus all of my energy and fully participate in rehearsals to the best of my abilityI will respect the rehearsal space and buildingAt the end of rehearsal I will make sure all of my belongings are taken with meI will treat my music and materials with respect and careI understand I will be learning music styles from different parts of the world and different cultures and those cultures need to be appreciated and respectedI understand failure to meet these expectations may result in removal from the choir
Student Signature*

Powered by Jotform SignClear
Parent Agreement

This portion needs to be gone over, filled out, and signed by the parent/guardian of the student
As the parent/guardian of the Gateway Community Youth Chorus member I commit to:*

I will drop off and pick up my student on timeI understand this is for active learning and not a childcare programI will support my student's learning outside of rehearsal to the best of my abilityI will be sure to check my email frequently for GCYC updatesI will attend the parent meeting during the 1st rehearsal on September 10th
Are you interested in volunteering as a rehearsal chaperone*

YesNo
Parental Consent
The Undersigned, Being a Parent or Guardian of the above named minor releases the Gateway Regional Arts Center, henceforth referred to as "GRAC", its representatives, agents, servants, and employees from liability for any injury to said minor, resulting from any cause whatsoever occurring to said minor at any time while attending the 2023 GRAC Summer Camps, excepting only injury or damage resulting from willful acts of such representatives, agents, servants and employees. The GRAC is also released of any expenses resulting from the injury.

To protect the safety of all students, the GRAC has no-tolerance policies that could immediately result in students being sent home. These policies include but are not limited to:

1. Use of violence or possession of weapons

2. Use of alcohol or drugs

Parents or guardians of students who violate policies will be notified to pick up their child.
Parental Consent: Parent/Guardian Signature*

Powered by Jotform SignClear
Student Medical Information
Student Date of Birth*

MonthDayYear
Date
Do you have Health Insurance coverage for this student?*

YesNo
Health Insurance Company
Health Insurance Policy Number
Does the student have any allergies?*

YesNo
List all allergies and the type of reaction they cause
Does the student have an epi-pen? If so, they must keep it with them at all times!

YesNo
Has the the student been diagnosed with asthma by a physician?*

YesNo
Has the student been diagnosed with any mental health issues?

YesNo
If yes, please describe any accommodations needed, and the best way for us to support the student.
Does the student have any cognitive or physical disabilities?

YesNo
If yes, please describe any accommodations needed, and the best way we can support the student.
Does the student have any other significant health history (heart condition, diabetes, any injury) the instructor needs to be aware of?*

YesNo
If Yes, please explain
Emergency Contacts
Primary Contact: In case of emergency, please contact the following person *

First NameLast Name
Primary Contact relationship to student*
Primary Contact Phone Number*

Area CodePhone Number
Secondary Contact: In case of emergency, please contact the following person *

First NameLast Name
Secondary Contact relationship to student*
Secondary Contact Phone Number*

Area CodePhone Number
Medical Information Signature
I have read and understand the statements in this release form. I understand that should a health problem arise, I will be notified but if I cannot be reached by telephone I consent to emergency medical treatment, which may include surgery for my child as deemed necessary by competent medical personnel. I also consent to the release of information for insurance purposes.
Parent/Guardian Name*

First NameLast Name
Medical Information: Parent/Guardian Signature*

Powered by Jotform SignClear
Social Media and Photography Release Form

I give my permission for my student's photograph to be used on social media and the GRAC website.
Social Media and Photo Release Parent/Guardian Signature:*

Powered by Jotform SignClear
Should be Empty:

2024 Gateway Community Youth Chorus Member Agreement

General Information

Attendance Policy

Member Agreement

Parent Agreement

Parental Consent

Student Medical Information

Emergency Contacts

Medical Information Signature

Social Media and Photography Release Form