2022-23 Children’s Music Registration

Register Here

Student Information
Student Name / Grade Level*
Student Name Grade Level
Parent/Guardian Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Emergency Contact
Different from parent/guardian.
Name*
First Last
Phone*
Alternate Phone
Photo/Video Release
I grant Zion Lutheran Church the right to photograph and/or video my child(ren) in connection with Children's Music events. I authorize Zion Lutheran Church, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I have read and understand the above:
Signature*
Name*
First Last
Relationship to Student(s)*
- I DO NOT authorize Zion Lutheran Church to photograph and/or video my child(ren).
Comments:
Please comment the skill level or if your child has any previous music experience, so we can group children accordingly
Phone
This field is for validation purposes and should be left unchanged.

Student Name	Grade Level