Child's Name*
Ethnic Data
State and local grants require the choir to report ethnic data
Choose Your Session*

Guardian 1*
Guardian 2*
How did you hear about this event?
In the unlikely event that my child becomes ill or is injured, and I cannot be immediately contacted at the time of an emergency, and if in the judgement of the staff of the Indianapolis Children's Choir immediate observation or treatment is necessary, I authorize and direct the staff to send my child (properly accompanied) to the hospital or physician most easily accessible. I also give permission for dispensing of over the counter medicines (i.e. Tylenol, Tums, Ibuprofen, etc.) as deemed necessary by the ICC staff or the designated medical personnel. I release the Indianapolis Children's Choir, their employees, and agents from any claim of liability in connection therewith.*
Date Agreed to Medical Release*
: :  
This waiver gives permission for the use of name, images, pictures, and recordings of my child (stated previously) by the Indianapolis Children's Choir without compensation except as may be agreed in advance for certain projects, this permission being a waiver as to all choir functions regardless of payment or other benefits to the choir.*
Date Agreed to Media Waiver*
: :  
Name on card*
Billing Address*
Register my singer*
Register my singer, cont.*
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