Ages 5-21 Only!
Register your child below. Youth Choirs Must Register Individual Students Separately
Select One
Please Select
Male
Female
Student Name (one form per student)
*
First Name
Last Name
Select age (must be at least 5 years old)
*
Please Select
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Name of person completing this form
*
First Name
Last Name
Relationship to student
*
Please Select
Self
Parent
Grandparent
Aunt
Uncle
Teacher
Youth Pastor
Pastor
Other Guardian
Email
*
example@example.com
Church
*
Pastor
*
City State
*
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
In your absence, provide the name of person authorized to pick up your child from rehearsal
First Name
Last Name
1. Hold Harmless & Liability Release - By submitting this application, I acknowledge that participation in this program is voluntary and at my own risk. I agree to hold harmless and release Music2Change U, PNH Foundation, Spiritfest, ERay promotions, the Arena District and all affiliated organizers, staff, employees, and volunteers from any liability for accidents, injuries, or incidents that may occur during the rehearsal(s), concert or related activities, whether on or off the premises. 2. Video & Photo Release grants Music2Change U, PNH Foundation, Spiritfest, ERay promotions, the Arena District the unrestricted right and permission to record, photograph, and/or otherwise capture my (or my child’s) image, likeness, and voice during the above program or related activities. I authorize the organizations listed above to edit, reproduce, distribute, and publicly display such recordings or images in any media format—now known or later developed—for lawful purposes including promotional, educational, and informational use. I understand that: No compensation or payment will be provided for participation or for use of any media created. All materials, recordings, and images remain the property of Music2ChangeU/PNH Foundation. I waive any right to inspect or approve the final materials or their use.
*
yes
I understand Parents and/or Guardians must purchase a ticket to SpiritFest show as there are no chaperones provided for SpiritFest. Drops Offs Are Not Allowed.
*
Please Select
Yes I Understand
Signature that I've read the registration details
*
Submit
Should be Empty: