Amity Children's Chorus

Registration Form *This question is required.

Student Information

First name
Last name

Date of birth This question requires a valid date format of MM/DD/YYYY.

calendar

Sex

Parent Information

First name
Last name
Phone
Email

Home Address

Emergency Contact Information

Name
Phone
Relationship to child

Medical Concerns

Please indicate if there are any special learning needs that I should be aware of. If there are, we can work together to make appropriate accommodations.

Please describe any allergies below.

Additional Information

Please share any additional information that you feel is important for me to know about your child (i.e. shy in new situations).

Please briefly describe any previous singing and/or music experience.

1. Tuition

10-Week Session, Thursdays 5:30 - 6:30 PM, 1/18/18 - 3/22/18 $185.00

Payment Options

Please select one of the following payment options:
*This question is required.

Terms and Conditions

In the event of insufficient enrollment, a full refund will be given. Refunds will not be given after the first day of the session.

Rebecca Geary
Amity Children’s Chorus
70 Lebanon Rd
Bethany, CT 06524

AmityChildrensChorus@gmail.com
www.MusicalFolk.com