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              Singer #1 Age
              
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              Singer #2 Age
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Singer #3 Age
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Singer #4 Age
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Payment Method
              
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                Cash, check or Venmo is acceptable. We will have a registration table at our December 8 concert where you can deliver payment, or you can mail your payment to the address listed below.
                
                  
                
                  
                
                  
                
               
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              PLEASE NOTE: In the event I need to cancel my child's registration after December 10, 2025 I will not be refunded
              
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              How did you hear about our program?
              
             
          
                
                
                  
                
                  
                
                  
                
                  
                
               
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              How did you hear about us?
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Parent/Legal Guardian's Name
              
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              Address
              
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              Mobile Phone
              
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              In case of emergency, please contact:
              
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              Emergency Contact's Relationship to Child:
              
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              Phone Number for Emergency Contact
              
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              Statement of Consent
              
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                 In the event of an emergency or non-emergency situation requiring medical treatment, I hereby grant permission for any and all medical and/or dental attention to be administered to my child/children, in the event of an accidental injury or illness, until such time as I can be contacted. This permission includes, but is not limited to, the administration of first aid, the use of an ambulance, and the administration of anesthesia and/or surgery, under the recommendation of qualified medical personnel. *
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Hold Harmless Statement
              
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                As a part of the agreement for the choir members to use church facilities at Parkview Baptist, each member is asked to read and sign the following Hold Harmless Statement in order for the family to participate in any choir activities.  
Each member covenants to the following:
1. As a parent, I assume all responsibility for any accident or injury, or any other loss resulting from participation in Choir activities and use of church grounds and other church facilities. I will hold-harmless the Choir leadership, their families, and Parkview Baptist.
2. I agree that if an injury occurs while participating in the Choir activities I will not, under any circumstance, submit a claim against Parkview Baptist, the Choir leaders, or any insurer of either organization, but rather use my own private insurance coverage, and accept personal responsibility for all such injury or other loss expenses.
3. I have either: 1) Inspected the facility and have informed Parkview Baptist and the Choir leadership of any safety concerns or; 2) Accept the facility “as is” and assume all responsibility for accident and/or injury for myself and/or any of my family members. I realize I am under no obligation to use the facility.
Each parent understands that they, and their children, are participating in the Choir activities at Parkview Baptist at their own risk. The parent may request access to the facility for inspection from the directors or Facilities Coordinator.
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Media Release:
              
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                Please note - Harmony Homeschool Choir may occasionally use photos and/or video of the choir in our promotional items on our website, Facebook, YouTube etc. By registering, you are agreeing to our ability to use these items in our promotional material.