Fall 2022/Spring 2023 Registration Form

Fall 2025/ Spring 2026 Registration

1st Session
Only one chorister may be registered at a time.
Chorister's Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date*

MonthDayYear
Gender:*

MaleFemale
Phone Number*

Area CodePhone Number
E-mail Address: (to receive confirmation and semester information):*
example@example.com
Chorister's Grade Level:*
Name of School:
PARENT / GUARDIAN INFORMATION
Parent / Guardian Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent Guardian Phone Number:

Area CodePhone Number
Emergency Contact Name: (if parent/guardian not available):*

First NameLast Name
Emergency Contact Relationship:*
Emergency Contact Day Phone Number:*

Area CodePhone Number
Liability/Photo/Video Release
I hereby give permission for the aforementioned chorister to attend and participate in Alaska Youth Choir activities and rehearsals. I hereby agree to hold harmless and release from liability the Alaska Youth Choir and any representative thereof for any action, claim, or damage that may arise as a result of his/her participation in choir activities. I hereby agree to comply with all rules and restrictions governing him/her set forth by Alaska Youth Choir and explained in the Handbook. I hereby give my permission for any authorized representative of Alaska Youth Choir to obtain service of and/or advice from an available physician or other medical personnel for him/her in case of illness or injury, including any necessary transportation for such emergency care. I hereby agree to assume ALL responsibility for any costs as a result of such medical care.

I furthermore understand the Alaska Youth Choir often takes photographs or videos of participants during its activities or events. I grant permission without compensation that these photographs or videos may be used in publications, presentations, websites or promotion of the Alaska Youth Choir and the HeART of Singing Summer Vocal Camp. The Alaska Youth Choir will not identify my child by name, or release any other personal information without additional written permission from me.
Electronic Signature: By entering my name below, I accept the above conditions and releases. (You must be 18 years old or over to sign below.)*

First NameLast Name
Relationship to registered chorister:*
Current Date:*

MonthDayYear
Schedule and Cost
Payment is due upon registration.

Tuition per semester: $200/chorister.

This is for 10 sessions of rehearsals.

With the hope of having a small concert at the end.

There are a total of 11-12 rehearsals built into the schedule

for possible cancellations.

AYC reserves right to substitute a Zoom session for In person rehearsal.

Fall 2025

September 16, 2025 thru December 16, 2025

All Rehearsals will be on Tuesdays at 6pm- 7pm @ Riverview Senior Living - 3041 Clinton Dr in the Valley.
Refund Policy
If a chorister has to withdraw it must be done in writing to the Business Administrator email alaskayouthchoir@gmail.com. The refund policy will be as follows (with 1^st rehearsal being counted as the 1^st day). If written withdrawal is received within:

2 days of the 1^st rehearsal then 100% on the Tuition Agreement Amount for the chorister will be refunded minus a $20 administrative Fee.
- 8 days of the 1^st rehearsal then 75% on the Tuition Agreement Amount for the chorister will be refunded minus a $20 administrative Fee.
- 15 days of the 1^st rehearsal then 50% on the Tuition Agreement Amount for the chorister will be refunded minus a $20 administrative Fee.
- AYC will not refund any tuition after the 15th day - Unless concellations made by AYC results in less then 10 rehearsals. Then it will be processed at a prorated rate minus the administrative fee of $20.
*AYC strongly encourages attendance as a Choir depends on choristers listening and depending on each other. AYC also depends on reliable and timely tuition payments. Please email alaskayouthchoir@gmail.com if you have any questions.
Payments
Payment is due upon registration with one of the options below. How do you plan to pay?

Pay Pal/Credit CardMail in a Check - If Checked Pay Pal will not come upSubmit Scholarship Form - I understand if Scholarship is not granted payment is still expected. See below to upload form
To pay by PayPal or credit card, please pick one box below:
prevnext( X )
Donation$50.00
AYC Donation

Fall 2025- 10 Rehearsals/Zoom sessions$200.00
This is for 10 sessions

Spring 2026 - 10 Rehearsals/Zoom Sessions$200.00
This is for 10 Sessions

Either term: Pay $200 by check/scholarship:$ Free
Select if you plan to pay by check or to apply for a scholarship. This option is not free.

Quantity

Total $0.00
Please verify that you are human*
Mail in a check - Please List Choristers Name

Alaska Youth Choir

P.O. Box 33252

Juneau, AK 99803

Apply for Scholarship - The Akiyama Scholarship 2025-2026 Form can be found under this websites "Scholarship info" page. Download from website, complete and re upload here.

A Waiver for each Chorister must be signed and received before they can participate in AYC - The Waiver Form can be found under this websites "Members"page. Download from website, complete and re upload here.
Upload completed Akiyama Application 2025-2026

Browse Files
Akyama Scholarship Application Cancelof
Upload Completed Waiver

Browse Files
Waiver Cancelof
Upon completion of filling in all areas of form, click "Submit Form". Only one chorister may be registered at a time. You may click "Print Form" to print a copy of this form. Do you have questions or need help with online registration? Email Dominique at alaskayouthchoir@gmail.com.
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Fall 2025/ Spring 2026 Registration

PARENT / GUARDIAN INFORMATION

Liability/Photo/Video Release

Schedule and Cost

Refund Policy

Payments