PGC Satellite Registration

Singer First Name: Singer Last Name: Singer Preferred Name: Birth Date(MM/DD/YYYY): / / Singer Email Singer Phone Select Your Satellite Choir Location: Arizona School for the Arts (grades 5-8): Dolce Ensemble Western Sky Middle School (grades 6-9): Dolce Ensemble PGC is offering 2 Satellite Tracks: After-School Only or Full Immersion Both tracks are the same price. Please select whether you wish your child to take part in after-school only activities, or be fully a member of PGC, able to perform on all concerts, events, camps, and tours. School Grade (2024-2025 School Year) Ethnicity T-Shirt Size (sizes run small) Child Small Child Medium Child Large Child XL Adult Small Adult Medium Adult Large Adult XL Adult XXL Singer lives with? Parent/Guardian Name 1 (First and Last) Parent/Guardian 1 Email: Parent/Guardian 1 Phone: Preferred Texting number Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip: - Zip Suffix Permission to release address and phone number for possible car pool contact? Place of Employment Position/Title (if applicable) Parent/Guardian Name 2 (First and Last) Parent/Guardian 2 Email Parent/Guardian 2 Phone: Preferred Texting Number Would you like Parent 2 to also receive emails and phone messages? Place of Employement Position/Title (if applicable) Emergency Contact-other than primary adult Emergency Contact Phone Emergency Contact Relationship to Singer Special Needs Please explain special need if necessary. Dietary Needs/Preferences Allergies Allergy Management Is your allergen life threatening? Payment preference (Tuition)-Select up to 2 options Preferred Payment method Name on Account: Name of Bank: Account Number: Routing Number: Name on Card: Card number: CVV (Verification Code) Billing Zip Code: How did you find PGC? If referred by a singer, teacher, or public event, who/what event? Waiver of Liability Photo Consent Financial liability and refund policy Electronic Signature Captcha