Registration Form

My son will be registering for the: *  Tour Choir
  Concert Choir
  Training Choir
Signup code (sent to you via email) *
Boy's First Name *
Boy's Last Name *
Nickname
Boy's date of birth *
Boy's current grade in school *
Primary Parent/Guardian First Name *
Primary Parent/Guardian Last Name *
Address *
City *
State *
Zip Code *
Home Phone *
Cell Phone
Emergency Contact Phone *
Primary Email Address *
Secondary Email Address
Second Parent/Guardian First Name
Second Parent/Guardian Last Name
Second Parent/Guardian Phone
Secondary Parent/Guardian Email Address
Address (if different from Primary Parent/Guardian)
City
State
Zip Code
Boy's Current School *
Boy's Current School Music Teacher *
IndemnificationI/We hereby grant permission for my/our child to participate in the activities of the Cincinnati Boychoir, Inc., including activities which occur both at the Boychoir facility (4501 Allison Street, Cincinnati, OH 45212), and off-site. I/We authorize the use of my/our son’s photograph for publicity purposes, as related to the choir. In consideration of any educational and musical benefits which may be realized by my child from association with any of the above-named organizations, and/or individuals, and intending to be legally bound by all the terms of this document, I do hereby waive any and all claims, charges and/or damages, present or future, which my child may have against the Cincinnati Boychoir, Inc., its Artistic Director, its staff, any member of its Board of Trustees, any adult chaperone, and/or any other organizations under whose auspices or in whose premises my child may rehearse or perform, and/or individuals and/or organizations providing transportation for my child. I/We do hereby expressly stipulate and agree to indemnify and forever hold harmless any and all of the said persons and/or organizations, and I do agree separately, intending to be legally bound hereby, to reimburse to any of the above-mentioned persons and/or organizations, any and all expenses which may be incurred by them in defense of any complaints, and/or actions, and/or testimonies brought by any member of my family against any of them. I/We acknowledge that all creative and/or performance work that my child does while under the auspices of the Cincinnati Boychoir, including audio and/or video recordings, are the sole property of the Cincinnati Boychoir and all rights for reproduction are the sole property of the Cincinnati Boychoir.
Please initial here to accept the indemnification: *
Does your son have, or is he subject to (check all that apply):
  Asthma
  Fainting Spells
  Seizures
  Diabetes
  Heart Trouble
Please list any allergies that your son has:
Please list any medications that your son currently takes:
Please list any other medical restrictions your son has:
Do you give permission for your son to be given Tylenol, Tums, Ibuprofen, Kaopectate, Robitussin, etc.? * Yes
No
Heath History ConfirmationPlease read the following and write your full name in the box below to agree: "This health history is correct so far as I know, and the person described herein has permission to engage in all prescribed activities, except as noted. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the adult leader in charge to hospitalize, secure proper anesthesia for, order injections for, and otherwise medically treat my son as deemed necessary."
Parent Authorization *
Please check the box if you anticipate needing to apply for financial aid at any point this year.
I am willing to volunteer time to the Boychoir in the following way/s
  Tour chaperone
  Concert chaperone
  Choir parent
  Concert helper/usher
  Concert merchandise or ticket sales
  Parent pledge drive
  Other (please contact me)
Additional ContactsAre there additional friends and/or family members who you'd like us to send information to regarding concerts? Please fill out the (optional) contact information below.
First Name
Last Name
Email Address
Address
City
State
Zip Code
Relationship to choirboy  Grandparent
  Cousin
  Other relative
  Friend
First Name
Last Name
Email Address
Address
City
State
Zip Code
Relationship to choirboy  Grandparent
  Cousin
  Other relative
  Friend
First Name
Last Name
Email Address
Address
City
State
Zip Code
Relationship to choirboy  Grandparent
  Cousin
  Other relative
  Friend