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    This document is a registration form for young Americans to participate in a 3-day music workshop hosted by The Mainstage Center for the Arts. It collects information such as the child's name, contact details, t-shirt size, and emergency contacts. There is a $80 registration fee and participants must return the form with payment by September 1, 2008. The form also provides information about the workshop, noting that it will be led by 36 performers to transform 300 students through music in areas like teamwork, respect, and self-worth.

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    T-Shirt Size (Adult Sizes) Xs SM Med LG XL XXL

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    mainstage
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    This document is a registration form for young Americans to participate in a 3-day music workshop hosted by The Mainstage Center for the Arts. It collects information such as the child's name, contact details, t-shirt size, and emergency contacts. There is a $80 registration fee and participants must return the form with payment by September 1, 2008. The form also provides information about the workshop, noting that it will be led by 36 performers to transform 300 students through music in areas like teamwork, respect, and self-worth.

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    This document is a registration form for young Americans to participate in a 3-day music workshop hosted by The Mainstage Center for the Arts. It collects information such as the child's name, contact details, t-shirt size, and emergency contacts. There is a $80 registration fee and participants must return the form with payment by September 1, 2008. The form also provides information about the workshop, noting that it will be led by 36 performers to transform 300 students through music in areas like teamwork, respect, and self-worth.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    55 views3 pages

    T-Shirt Size (Adult Sizes) Xs SM Med LG XL XXL

    Uploaded by

    mainstage
    This document is a registration form for young Americans to participate in a 3-day music workshop hosted by The Mainstage Center for the Arts. It collects information such as the child's name, contact details, t-shirt size, and emergency contacts. There is a $80 registration fee and participants must return the form with payment by September 1, 2008. The form also provides information about the workshop, noting that it will be led by 36 performers to transform 300 students through music in areas like teamwork, respect, and self-worth.

    Copyright:

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    YOUNG AMERICANS REGISTRATON FORM:

    Please return this form with check made payable to: The Mainstage Center for the Arts (MCA) by
    September 1, 2008. Checks must include phone number. Your cancelled check will serve as your receipt.

    REGISTRATION FEE: $80.00 per participant.

    Childʼs Name: _____________________________________ Parentʼs Name____________________________

    Address:_____________________________________________________________________________
    _
    City, State, Zip:_____________________________________________________________________________

    Telephone Number: (________) _________________________________

    Parent Cell # ( ) Parent E-Mail ________________________

    Name of School: ______________________________ Grade in Fall ʻ08________

    Name of Principal:______________________________________________________________

    Telephone # of School ____________________ Fax # for School________________

    T-SHIRT SIZE (Adult Sizes) XS SM MED LG XL XXL

    ____ I am willing to host 2 Young Americans.

    ____ I am NOT willing to host 2 Young Americans.

    ____ I am willing to volunteer some time during the three day workshop.

    RETURNED CHECK CHARGE: ALL CHECKS RETURNED BY YOUR BANK WILL BE SUBJECT TO A $35.00
    RETURN CHECK CHARGE. RETURNED CHECKS MUST BE REPLACED WITH A CERTIFIED CHECK,
    CASHIERS CHECK OR MONEY ORDER AND MUST INCLUDE THE ADDITIONAL $35.00 CHARGE.

    PAYMENT OPTIONS: _______ CHECK _________CASH ______ CREDIT CARD (if paying via credit
    card please complete the authorization form below. Please be advised that there is a $2.00 service charge
    for credit card use.)

    Name of Cardholder:___________________________________ Card Number: ________________________

    Type of Credit Card: Visa Master Card Exp. Date____________________

    Authorizing Signature: ________________________________________ Date: ____________

    Please note: pictures of these workshops and rehearsals will be taken for archival and publicity
    purposes.
    EMERGENCY INFORMATION

    Childʼs Name: ________________________________________________________

    Parent or Guardianʼs Names:____________________________________________

    Telephone Number: (home)______________________ (work)_________________

    (cell)_________________________ parent email ___________________________

    In case of emergency notify:_____________________________________________

    Telephone Number;____________________________________________________

    Name of Doctor:______________________ Telephone :_______________________

    Hospital Preference:___________________________________________________

    Insurance Carrier and number:___________________________________________

    Allergies:_____________________________________________________________

    Medications:__________________________________________________________

    Pertinent medical history:_______________________________________________

    _____________________________________________________________________

    ______________________________
    Parent or Guardian Signature

    HOW 36 PERFORMERS TRANSFORM 300 STUDENTS IN 3 DAYS!

    Designed for those with lots of talent and training


    AND for those who just love to sing!

    Music brings people together for many purposes: teamwork,


    respect, accomplishment, caring & self-discipline, a sense of
    living in understanding in self-worth and MUCH more.

    The Music Outreach Program aims to:
1. Encourage music in the


    schools of our nation and the world.
2. Train young people in
    performance.
3. Share insight and understanding of different
    cultures.
4. Strengthen character and develop self-esteem, self-
    worth and self-discipline.

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