ICC Foundations Registration 2023-2024

Child's Name*

First Name

Last Name

Age*

Born*

Singer's Shirt Size*

Ethnic Data

American Indian Asian or Pacific Islander Black/African American Hispanic White/Caucasian Other

State and local grants require the choir to report ethnic data

Choose Your Session*

Indianapolis, Fall, Thursdays 5:30-6:30pm Carmel, Fall, Mondays 4:45-5:45pm Indianapolis, Spring, Thursdays 5:30-6:30pm Carmel, Spring, Mondays 4:45-5:45pm

Preferred Email*

Confirm Preferred Email *

Other Email

Confirm Other Email *

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Guardian 1*

First Name

Last Name

Relationship to Child - Guardian 1

Cell Phone Number*

Home Phone Number

Guardian 2*

First Name

Last Name

Relationship to Child - Guardian 2

Cell Phone Number*

Home Phone Number

How did you hear about this event?

Friend or colleague Search Engine Advertisement

Other:

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.*

I agree to the Medical Release

Date Agreed to Medical Release*

: :

Please list any special health problems, allergies, and learning disabilities of singer*

Please list any dietary restrictions

Please list any medications being taken by singer*

Does your child carry an epipen?*

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.*

I agree to the media waiver

Date Agreed to Media Waiver*

: :

Name of your local newspaper

Discount code

Credit Card

Name on card*

First Name

Last Name

Billing Address*

Address Line 1

City

State

ZIP Code

Register my singer*

I agree to promptly pay the required fees for my child to participate in the Indianapolis Children’s Choir for the 2023-2024 season and to have the charges charged to my credit card

Register my singer, cont.*

In the event that the Indianapolis Children’s Choir (ICC) must suspend in-person instruction because of travel/group gathering restrictions imposed as a result of COVID, the ICC will provide personalized online instruction in vocal technique, pedagogy, music theory, sight reading, and repertoire. I ( parent/ guardian) understand that this is a continuation and not a suspension of the season. I ( parent/ guardian) agree that there will be no change in the season’s tuition obligation and agree to pay the same tuition which would include the online instruction.

Registration Fee* $

Tuition* $

Convenience Charge* $

Total* $