High School Student Registration and Consent Form

High School Student Registration and Consent Form
Confidentiality

The Society respects your privacy and that of your youth. All information gathered on this form will be kept confidential unless otherwise consented to by the parent/guardian.

Society and choir members will respect each other’s privacy, personal boundaries, and confidentiality. As well, a music director and administrator will be present at Society activities to ensure respectful behaviour from all choir members.

The purpose of gathering the information on this form is to provide Voices in Motion Choral Society (the “Society”) information required to facilitate the activities of the youth participating in a Voices in Motion Choir and to be able to contact parents/guardians and/or emergency contacts.

This form is to be reviewed, completed, signed by parent/guardian.

Name

First NameLast Name
Preferred Pronouns
School
Grade
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I am registering to rehearse on:
Parent/Guardian Information
Name

First NameLast Name
Preferred Pronouns
Relationship to youth
Parent/Guardian Email
example@example.com
As a parent/guardian, I would like to be added to the mailing list to receive updates, performance information, and rehearsal reminders.
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Emergency Contact (if different from Parent/Guardian)

First NameLast Name
Emergency Contact Email
example@example.com
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
MEDIA CONSENT

I consent to the use of my photograph or likeness in any publication, videotape, pamphlet or promotion by Voices in Motion Choral Society (Society) or other agencies which are promoting or furthering the mission of the Society. I understand that I will not receive separate compensation or consideration from the Society or anyone else for the permission granted in this Consent nor for the actual publication or use of my photograph or likeness. By signing this Consent, I understand that I am releasing the Society from any and all liability that may occur as a direct or indirect result of my photograph, the release of my identity, or the public relations materials, including but not limited to the use of any quotations. I understand that my personal contact information will NOT be released without my permission.

I understand that my participation with the Society does NOT require me to agree to this media consent.
I have read the media consent above and:
Should be Empty:

High School Student Registration and Consent Form

Parent/Guardian Information