Parent/Guardian Name *
Parent/Guardian E-mail *
Parent/Guardian Phone *
Please list your primary phone number where you can be reached during the day.
Parent/Guardian Alternate Phone Student Name *
Student's Home Address
* Student Birthdate *
Student Grade in Fall 2018 * 6th 7th 8th Student Gender * Male Female Student T-Shirt Size * Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large Student School * Music Teacher
School music teacher, or if your child takes private lessons on an instrument or voice.
Voice Part *
What vocal range are you comfortable singing in?
Soprano Alto Baritone I don't know Student Ethnicity (optional - for grant purposes)
To select multiple options, hold down the Ctrl key while making selections.
African American Asian American Caucasian Hispanic/Latino Other Student Health and Safety *
Please indicate any allergies, medical conditions, or medications (epi-pens) that may affect your child's participation in Acappellooza Jr Camp. Enter NONE if there are no health or safety concerns for your child.
Emergency Contact Name *
Emergency Contact's relationship to Student *
Please indicate if this is a Parent, Grandparent, Friend of Family, etc.
Emergency Contact's Phone Number *
Please list the primary daytime phone number.
Emergency Contact's Alternate Phone Number Preferred Hospital *
FOR MEDICAL EMERGENCIES ONLY - I authorize The St. Louis Children's Choirs to transport my child to the hospital(s) selected. (To select more than one option, hold down the Ctrl key while clicking.)
Nearest/No preference Missouri Baptist Mercy/St. John's St. Louis Children's Hospital Cardinal Glennon Barnes Jewish St. Luke's St. Clare's St. Mary's Do Not take to hospital, contact parents How did you hear about Acappellooza Jr? * Special Notes/Comments
Please use this space for any unusual situations which camp staff should know about, including if anyone other than a parent is authorized to pick-up your child at the end of the camp day. *Note- please include a phone number for the authorized person and a note of which day(s) they may be picking up.
Medical Release * Photo Release * Terms and Conditions *
This field is for validation purposes and should be left unchanged.