New Singer Acceptance

Singer First Name: Singer Last Name: Singer Preferred Name Birth Date: / / Singer Email Singer Phone Choir Placement (2024-2025 Season) Bella (9th-12th) Dolce (6th-9th) Harmonia (2nd-5th) Encanta Ethnicity School Name School Grade (2024-2025 School year) School District School Type T-Shirt Size Child Small Child Medium Child Large Child XL Adult Small Adult Medium Adult Large Adult XL Adult XXL Singer lives with? Parent/Guardian Name (First and Last) Parent/Guardian Email: 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 for Parent Directory? Place of Employment Position/Title (if applicable) Parent Name 2 (First and Last) Parent 2 Email Parent 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 Relationship to Singer(s): 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 Payment Method preference Would you like to add an additional amount to your one time or monthly payment to contribute to needs-based financial aid at PGC? This additional amount would be entirely tax-deductible. If yes, how much and how often would you like to contribute? (Please enter a dollar amount and either "one time" or "monthly") 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? Number of Registering Singers: Waiver of Liability Financial liability and refund policy