RCCC Camerata Registration Grade 4

Rapid City Children's Chorus

Camerata Registration

Singer's Name *

First Name Last Name

*

Male Female

Select One *

Camerata

School 2018-19 *

Grade 2018-19 *

Parent/Guardian E-mail

Parent/Guardian Emergency Phone # *

- Area Code Phone Number

Singer's Birth Date *

Month Day Year

Parent/Guardian Names *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent/Guardian Primary Phone # *

- Area Code Phone Number

OK to send text

Parent/Guardian cell phone #

- Area Code Phone Number

Additional Parent/Guardian Name

First Name Last Name

Additional Parent/Guardian E-mail

Additional Parent/Guardian Primary Phone #

- Area Code Phone Number

Addtional Parent/Guardian Emergency Phone #

- Area Code Phone Number

T-shirt Size *

Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large

Please Select an Option *

I am sending a registration check to RCCC, PO Box 1528, RC, 57709 I am paying the registration fee through Paypal. I am making my registration deposit but wish to apply for tuition assistance I am paying the full tuition with paypal. I am sending a check for full tuition.

As parent or guardian of the above chorister, I hereby accept the conditions of enrollment and give permission for my child to participate in the Rapid City Children's Chorus and all activities sponsored by the RCCC. I agree to comply with all program regulations and hereby remove the Rapid City Children's Chorus and all representatives from any and all liability for injury or damages incurred while involved in this program. I also, hereby, give my consent for my child to be audio recorded, photographed and videotaped for promotional or informational materials, press media, and the RCCC web page, in connection with his/her participation in the RCCC program. I understand that the choristers will not be identified by name. Electronically sign this form by entering your initials here: *

Rapid City Children's Chorus 2018-19