Monday Night Registration Options: Online or Mail

Participant Name

This is the name the child would like to be called

First Name

Last Name

Participant Birthdate

MM

DD

YYYY

Participant Grade

Parent(s) Name

First Name

Last Name

Preferred Contact Phone

(###)

###

####

Secondary Contact Phone

(###)

###

####

Email 1

Email 2

Mailing Address

Prior and Current Music Experience (Optional)

Describe any previous music experience - HHAV, school or church - choral or instrumental, which instrument, etc.

Allergies, Medications or Medical/Behavioral Conditions

Image Release

Permission to use photos, no name included

Comments/Questions

OR