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Youth Choir

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YOUTH CHOIR

Please fill out this for if you are interested in joining Youth Choir, or just want to know more information.

Student Name *

First

Last

Student Email *

Home Phone

Student Cell Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birthday - Month/Day/Year

List all instruments that your student plays:

Parent Name (1) *

First

Last

Parent (1) Cell Phone

Parent (1) Email *

Parent Name (2)

First

Last

Parent (2) Cell Phone

Parent (2) Email

Parent (2) Address (if different from the student)

Address Line 1

Address Line 2

City

State

Zip Code

List all instruments that either parent plays:

Email