Lawrence Children's Choir » Our community in harmony since 1991 » Capo Registration – Class B (5:35 pm

Number of family members for Capo registration:*

1
2
3

Student #1 Name*

First Last

Student #1 Grade for Fall 2019*

Student #1 School for Fall 2019*

Student #2 Name*

First Last

Student #2 Grade for Fall 2019*

Student #2 School for Fall 2019*

Student #3 Name*

First Last

Student #3 Grade for Fall 2019*

Student #3 School for Fall 2019*

Are you a single custodial parent?*

Yes
No

Parent /Guardian #1 Name*

First Last

Parent/Guardian #1 Home Address*

Street Address City State Zip/ Postal Code

Parent/Guardian #1 Home Phone*

Parent/Guardian #1 Cell Phone*

Parent/Guardian #1 Email*

Enter Email Confirm Email

Parent /Guardian #2 Name

First Last

Same Address as Parent/Guardian #1?

Yes
No

Parent/Guardian #2 Home Address

Street Address City State Zip/ Postal Code

Parent/Guardian #2 Home Phone

Parent/Guardian #2 Cell Phone

Parent/Guardian #2 Email

Enter Email Confirm Email

How did you learn about LCC?*

Which choir member did you hear about LCC from?*

First Last

Which music teacher referred you?*

First Last

How did you hear about LCC?*

I (we) hereby give my (our) consent for the above-named child to be taken under the care, custody, control and supervision of Carolyn Welch, Holly Beneventi, Katie Stoltenberg, Lindsay Taylor Hatfield, Cinnamon Ramer, and/or any additional agents, officials or sponsors associated with the Lawrence Children’s Choir, Inc., in conjunction with rehearsals, classes, and performances in Lawrence, Kansas. In consideration of my (our) child’s participation, I (we) do hereby release and hold harmless the above named individuals and the Lawrence Children’s Choir, Inc., and its officers, directors, and agents for any suit or claim for damages which may arise affecting my (our) child while under the control, care and/or supervision of the above listed individuals, directly or indirectly causing any injuries to my (our) child (save grossly negligent behavior). This release of liability and hold harmless agreement is essential to the participation of my (our) child in such activities and, it is understood that if this agreement is not signed that my (our) child shall not participate in the activities above described. I also grant to Lawrence Children’s Choir my permission to use my minor child’s likeness in photograph(s)/video for advertising, promotion and publicity purposes, with or without identification of me or my minor child by name, in perpetuity. I will make no monetary or other claim against Lawrence Children’s Choir for the above-stated uses(s), if any, of the photographs(s)/video.

Please acknowledge these terms and conditions:*

Yes, I agree and accept these terms and conditions for my student(s) to participate.

Date*

Electronic Signature*

Are you planning to apply for a scholarship?*

Yes
No

Are you or a family member a LCC employee?*

Yes
No

Registration fee for scholarship applicant (pending approval)*

Price: $0.00

Registration fee for a LCC employee*

Price: $0.00

Registration fee for one student (Fall semester)*

Price: $140.00

Registration fee for two students (Fall Session)*

Price: $250.00

Registration fee for three students (Fall Session)*

Price: $420.00

Scholarship Application

You will be prompted to upload a copy of your free and reduced lunch letter from your school district - or a copy of the first page of last year's tax return with social security numbers blacked out based on your response below.

Please select one of the following eligibility requirements:*

Our household meets the eligibility requirements as outlined in the Child Nutrition Program Benefits Income Eligibility Guidelines (Free and Reduced Lunch)
Our household does not meet the eligibility requirements as outlined in the Child Nutrition Program Benefits Income Eligibility Guidelines (Free and Reduced Lunch)

Select method to provide documentation (documentation required for scholarship)*

Upload document
Mail documentation directly to LCC - due by August 31 each year
Other

Upload documentation from computer*

Either a copy of your free and/or reduced lunch program from your school district or the first page of last year's tax return with personal information blacked out.

Reason for Scholarship Request (Be as detailed as possible)

Please let us know how this scholarship will help your student and family. If you are applying due to extenuating circumstances, please explain:*

Household income*

Household size*

Number of students applying for a scholarship in household:*

One
Two
Three

Name

This field is for validation purposes and should be left unchanged.

Capo Registration – Class B (5:35 pm – 6:20 pm)

2019 Capo Registration for Fall Session (Class B)

Scholarship Application

Reason for Scholarship Request (Be as detailed as possible)